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Systemic immune presentations of Coxiella burnetii infection (Q Fever).
Semin Arthritis Rheum. 2010 Apr; 39(5):405-9.SA

Abstract

OBJECTIVES

Q fever is a worldwide zoonosis caused by Coxiella burnetii. Its presentation can be atypical, delaying and complicating the diagnosis. We report 7 cases of Q fever mimicking vasculitis, systemic inflammatory disease, or auto-immune disorder.

METHODS

Seven cases of Q fever diagnosed between 1995 and 2007 in Nantes University Hospital (France) are described. They occurred in a nonendemic region and were selected on the basis of initial clinical presentation suggesting systemic immune disease. C. burnetii was detected using indirect immunofluorescence serology.

RESULTS

Q fever was acute in 4 of the 7 patients and chronic in 3. None had endocarditis. The initial presentations suggested Crohn's disease, Goodpasture's syndrome, polymyalgia rheumatica, adult-onset Still's disease, polyarteritis nodosa, giant-cell arteritis, and essential type II cryoglobulinemia. Two patients had antiphospholipid antibodies, 1 had transient IgG kappa monoclonal gammopathy, and 1 had polyclonal T CD8+ large granular lymphocyte expansion.

CONCLUSION

Clinicians must be aware of the potential diagnosis of Q fever, and C. burnetii serology is a helpful diagnostic tool in the investigation of fever of unknown origin with atypical systemic symptoms suggesting vasculitis or inflammatory disease.

Authors+Show Affiliations

Department of Infectious Diseases, University Hospital, Nantes, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

19110298

Citation

Lefebvre, Maeva, et al. "Systemic Immune Presentations of Coxiella Burnetii Infection (Q Fever)." Seminars in Arthritis and Rheumatism, vol. 39, no. 5, 2010, pp. 405-9.
Lefebvre M, Grossi O, Agard C, et al. Systemic immune presentations of Coxiella burnetii infection (Q Fever). Semin Arthritis Rheum. 2010;39(5):405-9.
Lefebvre, M., Grossi, O., Agard, C., Perret, C., Le Pape, P., Raoult, D., & Hamidou, M. A. (2010). Systemic immune presentations of Coxiella burnetii infection (Q Fever). Seminars in Arthritis and Rheumatism, 39(5), 405-9. https://doi.org/10.1016/j.semarthrit.2008.10.004
Lefebvre M, et al. Systemic Immune Presentations of Coxiella Burnetii Infection (Q Fever). Semin Arthritis Rheum. 2010;39(5):405-9. PubMed PMID: 19110298.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Systemic immune presentations of Coxiella burnetii infection (Q Fever). AU - Lefebvre,Maeva, AU - Grossi,Olivier, AU - Agard,Christian, AU - Perret,Christophe, AU - Le Pape,Patrice, AU - Raoult,Didier, AU - Hamidou,Mohamed A, Y1 - 2008/12/24/ PY - 2008/03/10/received PY - 2008/09/02/revised PY - 2008/10/01/accepted PY - 2008/12/27/entrez PY - 2008/12/27/pubmed PY - 2010/8/4/medline SP - 405 EP - 9 JF - Seminars in arthritis and rheumatism JO - Semin Arthritis Rheum VL - 39 IS - 5 N2 - OBJECTIVES: Q fever is a worldwide zoonosis caused by Coxiella burnetii. Its presentation can be atypical, delaying and complicating the diagnosis. We report 7 cases of Q fever mimicking vasculitis, systemic inflammatory disease, or auto-immune disorder. METHODS: Seven cases of Q fever diagnosed between 1995 and 2007 in Nantes University Hospital (France) are described. They occurred in a nonendemic region and were selected on the basis of initial clinical presentation suggesting systemic immune disease. C. burnetii was detected using indirect immunofluorescence serology. RESULTS: Q fever was acute in 4 of the 7 patients and chronic in 3. None had endocarditis. The initial presentations suggested Crohn's disease, Goodpasture's syndrome, polymyalgia rheumatica, adult-onset Still's disease, polyarteritis nodosa, giant-cell arteritis, and essential type II cryoglobulinemia. Two patients had antiphospholipid antibodies, 1 had transient IgG kappa monoclonal gammopathy, and 1 had polyclonal T CD8+ large granular lymphocyte expansion. CONCLUSION: Clinicians must be aware of the potential diagnosis of Q fever, and C. burnetii serology is a helpful diagnostic tool in the investigation of fever of unknown origin with atypical systemic symptoms suggesting vasculitis or inflammatory disease. SN - 1532-866X UR - https://www.unboundmedicine.com/medline/citation/19110298/Systemic_immune_presentations_of_Coxiella_burnetii_infection__Q_Fever__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0049-0172(08)00193-5 DB - PRIME DP - Unbound Medicine ER -