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Q fever meningoencephalitis in five patients
M Drancourt1, D Raoult, B Xeridat
1Centre National de Référence des Rickettsioses C.H.U. La Timone, Marseille, France.
Abstract:
Within the last four years, we have observed five patients with epidemiological, clinical, and serological features that were consistent with Q fever meningoencephalitis. Attempts to isolate Coxiella burnetii from the cerebrospinal fluid of two patients were unsuccessful. Neurological features ranged from coma, general seizures, confusion, to palsy and meningitis. All patients were febrile. These patients were neuroradiologicaly investigated. Since 1984, four other cases have been reported in the literature. Antibiotics with good penetration into the cerebrospinal fluid, such as new quinolones, may be useful for treatment of confirmed cases. Q fever should be considered as a possible etiology of meningitis in endemic areas, and diagnosis should be confirmed by serology.
Insights
Q fever meningoencephalitis presents with diverse neurological symptoms. Early consideration and serological confirmation are crucial for timely diagnosis and treatment in endemic regions.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiology
Background:
- Q fever, caused by Coxiella burnetii, is a zoonotic illness.
- Meningoencephalitis is a serious inflammation of the brain and meninges.
Observation:
- Five recent patients presented with Q fever meningoencephalitis.
- Neurological manifestations included coma, seizures, confusion, palsy, and meningitis.
- Cerebrospinal fluid cultures for Coxiella burnetii were negative in two patients.
Findings:
- Epidemiological, clinical, and serological data supported Q fever meningoencephalitis diagnosis.
- Literature review identified four additional cases since 1984.
Implications:
- Q fever should be considered in meningitis cases in endemic areas.
- Serological confirmation is vital for diagnosis.
- Antibiotics like new quinolones may aid treatment due to cerebrospinal fluid penetration.