Chronic Q Fever Diagnosis— Consensus Guideline Versus Expert Opinion

Overview

Journal Emerg Infect Dis

Specialty Infectious Diseases

Date 2015 Aug 18

PMID 26277798

Citations 35

Authors

Linda M Kampschreur

Marjolijn C A Wegdam-Blans

Peter C Wever

Nicole H M Renders

Corine E Delsing

Tom Sprong

Marjo E E van Kasteren

Henk Bijlmer

Daan Notermans

Jan Jelrik Oosterheert

Frans S Stals

Marrigje H Nabuurs-Franssen

Chantal P Bleeker-Rovers

Affiliations

Soon will be listed here.

Abstract

Chronic Q fever, caused by Coxiella burnetii, has high mortality and morbidity rates if left untreated. Controversy about the diagnosis of this complex disease has emerged recently. We applied the guideline from the Dutch Q Fever Consensus Group and a set of diagnostic criteria proposed by Didier Raoult to all 284 chronic Q fever patients included in the Dutch National Chronic Q Fever Database during 2006–2012. Of the patients who had proven cases of chronic Q fever by the Dutch guideline, 46 (30.5%)would not have received a diagnosis by the alternative criteria designed by Raoult, and 14 (4.9%) would have been considered to have possible chronic Q fever. Six patients with proven chronic Q fever died of related causes. Until results from future studies are available, by which current guidelines can be modified, we believe that the Dutch literature-based consensus guideline is more sensitive and easier to use in clinical practice.

Citing Articles

Real-time PCR detection of Coxiella burnetii in dairy products in Kwara State, Nigeria: a public health concern.

Elelu N, Chinedu N, Yakub-Obalowu B, Odetokun I, Al-Mustapha A BMC Vet Res. 2025; 21(1):8.

PMID: 39773743 PMC: 11706007. DOI: 10.1186/s12917-024-04449-2.

Shedding light on risk: Seroprevalence of Q fever among farm animals and workers in Ecuador.

Guerrero-Freire M, Ledesma Y, Echeverria G, Blanco F, de Waard J One Health. 2024; 19:100939.

PMID: 39717536 PMC: 11663977. DOI: 10.1016/j.onehlt.2024.100939.

Q Fever Endocarditis: A Challenging Diagnosis in a Patient Referring Weight Loss and Anorexia, and With Granulomas in Gastric Biopsy Specimens.

Lago-Rodriguez A, Fraile-Ribot P, Amengual-Antich I, Gual-Capllonch F, Garcia-Gasalla M Clin Case Rep. 2024; 12(12):e9635.

PMID: 39619303 PMC: 11606930. DOI: 10.1002/ccr3.9635.

Navigating Q fever: Current perspectives and challenges in outbreak preparedness.

Meles D, Khairullah A, Mustofa I, Wurlina W, Akintunde A, Suwasanti N Open Vet J. 2024; 14(10):2509-2524.

PMID: 39545195 PMC: 11560256. DOI: 10.5455/OVJ.2024.v14.i10.2.

Q fever endocarditis of the tricuspid valve transmitted in an urban setting with no livestock exposure: Case report.

Habedank D, Bublak A, Habedank B BMC Infect Dis. 2024; 24(1):766.

PMID: 39090536 PMC: 11293036. DOI: 10.1186/s12879-024-09629-x.

References

Li J, Sexton D, Mick N, Nettles R, Fowler Jr V, Ryan T . Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000; 30(4):633-8. DOI: 10.1086/313753. View

Raoult D, Tissot-Dupont H, Foucault C, Gouvernet J, Fournier P, Bernit E . Q fever 1985-1998. Clinical and epidemiologic features of 1,383 infections. Medicine (Baltimore). 2000; 79(2):109-23. DOI: 10.1097/00005792-200003000-00005. View

Wegdam-Blans M, Vainas T, van Sambeek M, Cuypers P, Tjhie H, van Straten A . Vascular complications of Q-fever infections. Eur J Vasc Endovasc Surg. 2011; 42(3):384-92. DOI: 10.1016/j.ejvs.2011.04.013. View

Delsing C, Kullberg B, Bleeker-Rovers C . Q fever in the Netherlands from 2007 to 2010. Neth J Med. 2011; 68(12):382-7. View

Million M, Thuny F, Richet H, Raoult D . Long-term outcome of Q fever endocarditis: a 26-year personal survey. Lancet Infect Dis. 2010; 10(8):527-35. DOI: 10.1016/S1473-3099(10)70135-3. View

Raoult D . Chronic Q fever: expert opinion versus literature analysis and consensus. J Infect. 2012; 65(2):102-8. DOI: 10.1016/j.jinf.2012.04.006. View

Kampschreur L, Oosterheert J, Koop A, Wegdam-Blans M, Delsing C, Bleeker-Rovers C . Microbiological challenges in the diagnosis of chronic Q fever. Clin Vaccine Immunol. 2012; 19(5):787-90. PMC: 3346333. DOI: 10.1128/CVI.05724-11. View

Wegdam-Blans M, Kampschreur L, Delsing C, Bleeker-Rovers C, Sprong T, van Kasteren M . Chronic Q fever: review of the literature and a proposal of new diagnostic criteria. J Infect. 2012; 64(3):247-59. DOI: 10.1016/j.jinf.2011.12.014. View

Dupont H, Thirion X, Raoult D . Q fever serology: cutoff determination for microimmunofluorescence. Clin Diagn Lab Immunol. 1994; 1(2):189-96. PMC: 368226. DOI: 10.1128/cdli.1.2.189-196.1994. View

10.

Musso D, Raoult D . Coxiella burnetii blood cultures from acute and chronic Q-fever patients. J Clin Microbiol. 1995; 33(12):3129-32. PMC: 228658. DOI: 10.1128/jcm.33.12.3129-3132.1995. View

11.

Raoult D, Houpikian P, Tissot Dupont H, Riss J, Brouqui P . Treatment of Q fever endocarditis: comparison of 2 regimens containing doxycycline and ofloxacin or hydroxychloroquine. Arch Intern Med. 1999; 159(2):167-73. DOI: 10.1001/archinte.159.2.167. View

12.

Maurin M, Raoult D . Q fever. Clin Microbiol Rev. 1999; 12(4):518-53. PMC: 88923. DOI: 10.1128/CMR.12.4.518. View

13.

Fenollar F, Fournier P, Raoult D . Molecular detection of Coxiella burnetii in the sera of patients with Q fever endocarditis or vascular infection. J Clin Microbiol. 2004; 42(11):4919-24. PMC: 525147. DOI: 10.1128/JCM.42.11.4919-4924.2004. View

14.

Landais C, Fenollar F, Thuny F, Raoult D . From acute Q fever to endocarditis: serological follow-up strategy. Clin Infect Dis. 2007; 44(10):1337-40. DOI: 10.1086/515401. View

15.

Botelho-Nevers E, Fournier P, Richet H, Fenollar F, Lepidi H, Foucault C . Coxiella burnetii infection of aortic aneurysms or vascular grafts: report of 30 new cases and evaluation of outcome. Eur J Clin Microbiol Infect Dis. 2007; 26(9):635-40. DOI: 10.1007/s10096-007-0357-6. View

16.

van der Hoek W, Dijkstra F, Schimmer B, Schneeberger P, Vellema P, Wijkmans C . Q fever in the Netherlands: an update on the epidemiology and control measures. Euro Surveill. 2010; 15(12). View