Clinical characteristics of acute Q fever in Daegu area.
- Author:
Kyoung Suk LEE
1
;
Young Sill CHOI
;
Ki Tae KWON
;
Mi Jung LEE
;
A Young SEO
;
Shin Won LEE
;
Seoung Woo HAN
;
Gun Woo KIM
;
Hyun Soo KIM
;
Chang Geun PARK
;
Kyung Rak SOHN
;
Shin Woo KIM
;
Hyun Ha CHANG
;
Seong Yeol RYU
Author Information
1. Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea. ktkwon@fatima.or.kr
- Publication Type:Original Article
- Keywords:
Hepatitis;
Granuloma;
Q-fever
- MeSH:
Animals;
Anorexia;
Azithromycin;
Biopsy;
Chills;
Coxiella;
Diagnosis, Differential;
Doxycycline;
Female;
Fever;
Granuloma;
Headache;
Hepatitis;
Hospitals, Teaching;
Humans;
Korea;
Liver;
Male;
Pneumonia;
Polymerase Chain Reaction;
Q Fever;
Thorax
- From:Korean Journal of Medicine
2010;79(4):404-411
- CountryRepublic of Korea
- Language:Korean
-
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.
