Korean J Med.
2010 Oct;79(4):404-411.
Clinical characteristics of acute Q fever in Daegu area
- Affiliations
-
- 1Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea. ktkwon@fatima.or.kr
- 2Division of Rickettsial and Zoonoses, Center for Immunology and Pathology, KNIH, Seoul, Korea.
- 3Department of Pathology, Daegu Fatima Hospital, Daegu, Korea.
- 4Department of Infectious Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
- 5Department of Infectious Disease, Keimyung University School of Medicine, Seoul, Korea.
Abstract
- BACKGROUND/AIMS
Although only a few sporadic cases of Q fever have been reported in Korea, a total of 13 cases have been seen in our area. We performed this study to evaluate the clinical characteristics of these cases of acute Q fever.
METHODS
Demographic features, clinical manifestations, laboratory and radiologic findings, and therapeutic outcomes of all cases were evaluated. Q fever was diagnosed using an indirect micro-immunofluorescence assay (MIFA) and polymerase chain reaction (PCR).
RESULTS
A total of 13 patients with acute Q fever seen from January 2006 to August 2008 at three teaching hospitals in the Daegu Metropolitan City area were enrolled. The mean age was 49 years old (range, 24~76), and the male to female ratio was 11:2. Six (46.2%) cases had a history of animal contact. Fever (100%) was the most common manifestation, followed by myalgia (84.6%), headache (61.5%), anorexia (61.5%), and chills (61.5%). All cases were diagnosed with high titers of anti-phase II antibody (IgM> or = 1:50, IgG> or =1:200) and positive nested PCR for the 27-kDa OMP com-1 gene of Coxiella burnettii in the blood. In three cases, liver biopsies revealed the presence of compact fibrin-ring granulomas. No characteristics of pneumonia were diagnosed on chest X-rays. The predominant presentation was acute febrile illness with hepatitis, including three cases (27.3%) of severe cholestatic hepatitis. The most frequently used antimicrobial agent was doxycycline (84.6%), followed by azithromycin (7.7%).
CONCLUSIONS
Acute Q fever may be added to the list of differential diagnosis of patients with acute febrile illness and hepatitis in the Daegu Metropolitan City area.
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