Q fever is a zoonotic infection caused by Coxiella burnetti, which has been previously regarded as an uncommon infectious disease in Korea but is sporadically reported recently. Common manifestations of acute Q fever usually present as influenza-like illness, pneumonia and occasionally hepatitis. Herein, we report 4 cases of acute Q fever as a cause of acute hepatitis and fever. All patients had fever and non-specific symptoms, and laboratory test showed acute hepatitis. Antibody surveys for many virus infections and bacterial cultures were negative. Finally, they were diagnosed acute Q fever by an indirect microimmunofluorescence test. Liver biopsy in 3 patients revealed granuloma including one with typical fibrin-ring. All patients had complete resolution of symptoms and signs with doxycycline treatment. Q fever should be considered in the differential diagnosis of patients with fever of unknown origin with acute hepatitis in Korea.
Acute Disease ; Adult ; Anti-Bacterial Agents/therapeutic use ; Coxiella burnetii/isolation & purification ; Doxycycline/therapeutic use ; Fluorescent Antibody Technique, Indirect ; Hepatitis/*diagnosis/etiology/pathology ; Humans ; Male ; Middle Aged ; Q Fever/complications/diagnosis/drug therapy ; Rifampin/therapeutic use