Clinical Features and Complications of Coxiella burnetii Infections From the French National Reference Center for Q Fever

Q fever remains widespread throughout the world; the disease is serious and causes outbreaks and deaths when complications are not detected. The diagnosis of Q fever requires the demonstration of the presence of Coxiella burnetii and the identification of an organic lesion. To describe the hitherto...

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Bibliographic Details
Published in:JAMA network open 2018-08, Vol.1 (4), p.e181580-e181580
Main Authors: Melenotte, Cléa, Protopopescu, Camélia, Million, Matthieu, Edouard, Sophie, Carrieri, M Patrizia, Eldin, Carole, Angelakis, Emmanouil, Djossou, Félix, Bardin, Nathalie, Fournier, Pierre-Edouard, Mège, Jean-Louis, Raoult, Didier
Format: Article
Language:English
Subjects:
Effectiveness
Endocarditis
Female
France
Gallbladder diseases
Human health and pathology
Humans
Infections
Infectious Diseases
Life Sciences
Lymphoma
Male
Middle Aged
Online Only
Original Investigation
Prospective Studies
Q Fever - complications
Q Fever - diagnosis
Q Fever - mortality
Risk Factors
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Summary:Q fever remains widespread throughout the world; the disease is serious and causes outbreaks and deaths when complications are not detected. The diagnosis of Q fever requires the demonstration of the presence of Coxiella burnetii and the identification of an organic lesion. To describe the hitherto neglected clinical characteristics of Q fever and identifying risk factors for complications and death. This prospective cohort study conducted from January 1, 1991, through December 31, 2016, included patients treated at the French National Reference Center for Q fever with serologic findings positive for C burnetii and clinical data consistent with C burnetii infection. Clinical data were prospectively collected by telephone. Patients with unavailable clinical data or an unidentified infectious focus were excluded. Q fever complications and mortality. Of the 180 483 patients undergoing testing, 2918 had positive findings for C burnetii and 2434 (68.8% men) presented with clinical data consistent with a C burnetii infection. Mean (SD) age was 51.8 (17.4) years, and the ratio of men to women was 2.2. At the time of inclusion, 1806 patients presented with acute Q fever, including 138 with acute Q fever that progressed to persistent C burnetii infection, and 766 had persistent focalized C burnetii infection. Rare and hitherto neglected foci of infections included lymphadenitis (97 [4.0%]), acute Q fever endocarditis (50 [2.1%]), hemophagocytic syndrome (9 [0.4%]), and alithiasic cholecystitis (11 [0.4%]). Vascular infection (hazard ratio [HR], 3.1; 95% CI, 1.7-5.7; P 
ISSN:2574-3805
2574-3805
DOI:10.1001/jamanetworkopen.2018.1580