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Subclinical chronic Q fever.

R J Fergusson, T R Shaw, A H Kitchin

    The Quarterly Journal of Medicine
    |October 1, 1985
    PubMed
    Summary
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    Subclinical chronic Q fever was detected in seven patients via serology. Long-term antibiotic treatment in some cases reduced antibody titres, but the optimal therapeutic approach for this asymptomatic infection remains unclear.

    Area of Science:

    • Infectious Diseases
    • Cardiology
    • Microbiology

    Background:

    • Chronic Q fever, caused by Coxiella burnetii, often presents with endocarditis but can manifest asymptomatically.
    • Routine serological screening for Coxiella burnetii phase I antibodies is crucial for identifying subclinical infections.

    Observation:

    • Seven patients with subclinical chronic Q fever were identified through routine screening before cardiac catheterization.
    • None exhibited overt symptoms of endocarditis, hepatitis, or other infection sites.
    • Cardiac tissue analysis and seroconversion confirmed Coxiella burnetii infection in some observed patients.

    Findings:

    • Three patients were monitored without antibiotics for 6-20 months, with one showing serological evidence of infection.
    • Four patients received prolonged dual-drug antibiotic therapy (4-6 years).

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  • Antibiotic treatment led to significantly reduced phase I antibody titres in three patients, with no overt disease recurrence.

    • Implications:

    • Subclinical chronic Q fever presents a therapeutic dilemma regarding the necessity and efficacy of antibiotic treatment.
    • The study highlights the potential for Coxiella burnetii to persist asymptomatically at various sites.
    • Further research is needed to establish optimal management strategies for asymptomatic Coxiella burnetii infections.