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Q fever: a contemporary case series from a Belgian hospital
Lore Vanderbeke1, Willy E Peetermans1,2, Veroniek Saegeman3
1a Department of Internal Medicine , University Hospitals Leuven , Leuven , Belgium.
Objectives:
Q fever is a global zoonosis that can cause both acute and chronic infections in humans through aerogenic transmission. Although Q fever was discovered already 80 years ago, this infectious disease remains largely unknown. We studied a case series in a Belgian tertiary care hospital.
Methods:
A laboratory and file query at our department was performed to detect patients who were newly diagnosed with Q fever from 01 January 2005 to 01 October 2014.
Results:
In total, 10 acute Q fever and 5 chronic Q fever infections were identified. An aspecific flu-like illness was the prevailing manifestation of acute Q fever, while this was infective endocarditis in chronic Q fever cases. Noteworthy are the high percentage of myocarditis cases in the acute setting and one case of amyloidosis as a manifestation of chronic Q fever. No evolution from acute to chronic Q fever was noted; overall outcome for both acute and chronic Q fever was favourable with a 94% survival rate.
Discussion:
Q fever is an infectious disease characterised by a variable clinical presentation. Detection requires correct assessment of the clinical picture in combination with a laboratory confirmation. Treatment and follow-up are intended to avoid a negative outcome.
Insights
Q fever, a zoonotic disease, presents with diverse symptoms. Early detection and laboratory confirmation are crucial for effective treatment and favorable outcomes in both acute and chronic cases.
Area of Science:
- Infectious Diseases
- Zoonoses
- Microbiology
Background:
- Q fever is a globally prevalent zoonotic disease caused by Coxiella burnetii.
- Despite its long history, Q fever remains underrecognized in clinical practice.
- Aerogenic transmission poses a significant risk for human infection.
Purpose of the Study:
- To investigate the clinical presentation and outcomes of Q fever cases.
- To highlight the diagnostic challenges and management strategies for Q fever.
- To analyze a case series from a Belgian tertiary care hospital.
Main Methods:
- Retrospective analysis of laboratory and patient files.
- Inclusion criteria: new Q fever diagnoses between January 2005 and October 2014.
- Data collection focused on clinical manifestations, diagnosis, and patient outcomes.
Main Results:
- Fifteen cases identified: 10 acute and 5 chronic Q fever infections.
- Acute Q fever commonly presented as flu-like illness; chronic cases often involved infective endocarditis.
- Notable findings include myocarditis in acute cases and amyloidosis in a chronic case.
Conclusions:
- Q fever exhibits a wide spectrum of clinical presentations, necessitating high clinical suspicion.
- Accurate diagnosis relies on integrating clinical assessment with laboratory confirmation.
- Appropriate treatment and diligent follow-up are essential for preventing adverse outcomes.
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