Differentiation of Acute Q Fever from Other Infections in Patients Presenting to Hospitals, the Netherlands

• Main Authors: Stephan P. Keijmel, Elmer Krijger, Corine E. Delsing, Tom Sprong, Marrigje H. Nabuurs-Franssen, Chantal P. Bleeker-Rovers
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2015-08-01
• Series: Emerging Infectious Diseases
• Subjects: Q fever; acute Q fever; chronic Q fever; case–control study; clinical practice; Coxiella burnetii
• Online Access: https://wwwnc.cdc.gov/eid/article/21/8/14-0196_article
• ISSN: 1080-6040; 1080-6059

Differentiating acute Q fever from infections caused by other pathogens is essential. We conducted a retrospective case–control study to evaluate differences in clinical signs, symptoms, and outcomes for 82 patients with acute Q fever and 52 control patients who had pneumonia, fever and lower respiratory tract symptoms, or fever and hepatitis, but had negative serologic results for Q fever. Patients with acute Q fever were younger and had higher C-reactive protein levels but lower leukocyte counts. However, a large overlap was found. In patients with an indication for prophylaxis, chronic Q fever did not develop after patients received prophylaxis but did develop in 50% of patients who did not receive prophylaxis. Differentiating acute Q fever from other respiratory infections, fever, or hepatitis is not possible without serologic testing or PCR. If risk factors for chronic Q fever are present, prophylactic treatment is advised.