Azithromycin for acute Q fever in pregnancy

Q fever is a zoonosis caused by Coxiella burnetii. Although data on Q fever during pregnancy are limited, they indicate that infection with C. burnetii is associated with high morbidity and mortality. The infection is usually asymptomatic in pregnant women but may result in obstetric complications such as spontaneous abortion, intrauterine growth retardation, intrauterine fetal death and premature delivery; in addition, pregnant women are at higher risk of developing chronic Q fever. Treatment of Q fever during pregnancy is challenging not only because C. burnetii is an intracellular bacterium but also because of safety restrictions and limited information on the efficacy of treatment. We report a case of acute Q fever in pregnancy with a successful outcome for mother and child, describe our therapeutic approach to the management of this case, and suggest that treatment with azithromycin may have prevented possible obstetric complications and evolution toward a chronic serologic profile in our patient.