Are fatigue symptoms and chronic fatigue syndrome following Q fever infection related to psychosocial variables?

Strauß, Bernhard; Löschau, Maria med.; Seidel, Thomas; Stallmach, Andreas; Thomas, Andrea

doi:10.1016/j.jpsychores.2012.01.010

Cited by 12 publications

(18 citation statements)

References 43 publications

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“…Several hypotheses regarding the etiology of QFS exist, varying from a biopsychological etiology with C. burnetii acting as trigger for fatigue development [6] and the determination of symptoms by host and genetic factors [36], to cytokine dysregulation, supported by low levels of C. burnetii DNA found in bone marrow aspirates, thin-needle liver biopsies, and blood mononuclear cells [37][38][39]. In addition, it should be noted that prevalence of chronic fatigue differs between studies in different countries [40].…”

Section: Discussionmentioning

confidence: 99%

“…Besides chronic Q fever (ie, persistent C. burnetii infection), which occurs in 1%-5% of cases [1], a debilitating fatigue syndrome has been described [2][3][4][5][6][7][8][9][10][11]. This Q fever fatigue syndrome (QFS) persists for years in approximately 20% of cases following acute Q fever [2][3][4][5][6][9][10][11]. Many QFS patients fulfill the case definition of chronic fatigue syndrome (CFS) [2,8,10,12].…”

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confidence: 99%

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Effectiveness of Long-term Doxycycline Treatment and Cognitive-Behavioral Therapy on Fatigue Severity in Patients with Q Fever Fatigue Syndrome (Qure Study): A Randomized Controlled Trial

Keijmel

Delsing

Bleijenberg

et al. 2017

Clinical Infectious Diseases

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Background. Approximately 20% of patients with acute Q fever will develop chronic fatigue, referred to as Q fever fatigue syndrome (QFS). The objective of this randomized controlled clinical trial was to assess the efficacy of either long-term treatment with doxycycline or cognitive-behavioral therapy (CBT) in reducing fatigue severity in patients with QFS.Methods. Adult patients were included who met the QFS criteria according to the Dutch guideline: a new onset of severe fatigue lasting ≥6 months with significant disabilities, related to an acute Q fever infection, without other somatic or psychiatric comorbidity explaining the fatigue. Using block randomization, patients were randomized between oral study medication and CBT (2:1) for 24 weeks. Second, a double-blind randomization between doxycycline (200 mg/day, once daily) and placebo was performed in the medication group. Primary outcome was fatigue severity at end of treatment (EOT; week 26), assessed with the Checklist Individual Strength subscale Fatigue Severity.Results. Of 155 patients randomized, 154 were included in the intention-to-treat analysis (doxycycline, 52; placebo, 52; CBT, 50). At EOT, fatigue severity was similar between doxycycline (40.8 [95% confidence interval {CI}, 37.3-44.3]) and placebo (37.8 [95% CI,.2]; difference, doxycycline vs placebo, −3.0 [97.5% CI, −8.7 to 2.6]; P = .45). Fatigue severity was significantly lower after CBT (31.6 [95% CI,.1]) than after placebo (difference, CBT vs placebo, 6.2 [97.5% CI, .5-11.9]; P = .03).Conclusions. CBT is effective in reducing fatigue severity in QFS patients. Long-term treatment with doxycycline does not reduce fatigue severity in QFS patients compared to placebo.Clinical Trials Registration. NCT01318356.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Effectiveness of Long-term Doxycycline Treatment and Cognitive-Behavioral Therapy on Fatigue Severity in Patients with Q Fever Fatigue Syndrome (Qure Study): A Randomized Controlled Trial

Keijmel

Delsing

Bleijenberg

et al. 2017

Clinical Infectious Diseases

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“…More recent studies have used a battery of different validated tests for evaluation of health status (SF-36, Chalder fatigue scale score, SF-12, MFI, SOMS, CDC-SI, Whiteley index, F-Sozu, and OQ-45) with duration of follow-up from 27 months to 6 years. They found a higher frequency (from 32% to 54%) of fatigue symptoms and impaired quality of life in patients who had experienced an episode of primary Q fever than in healthy controls (635)(636)(637). Strauss et al also found that patients with fatigue symptoms following Q fever in Germany were more frequently subject to hypochondriacal worries and beliefs and somatization (637).…”

Section: Other Related Clinical Syndromesmentioning

confidence: 99%

From Q Fever to Coxiella burnetii Infection: a Paradigm Change

et al. 2017

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Coxiella burnetii is the agent of Q fever, or "query fever," a zoonosis first described in Australia in 1937. Since this first description, knowledge about this pathogen and its associated infections has increased dramatically. We review here all the progress made over the last 20 years on this topic. C. burnetii is classically a strict intracellular, Gram-negative bacterium. However, a major step in the characterization of this pathogen was achieved by the establishment of its axenic culture. C. burnetii infects a wide range of animals, from arthropods to humans. The genetic determinants of virulence are now better known, thanks to the achievement of determining the genome sequences of several strains of this species and comparative genomic analyses. Q fever can be found worldwide, but the epidemiological features of this disease vary according to the geographic area considered, including situations where it is endemic or hyperendemic, and the occurrence of large epidemic outbreaks. In recent years, a major breakthrough in the understanding of the natural history of human infection with C. burnetii was the breaking of the old dichotomy between "acute" and "chronic" Q fever. The clinical presentation of C. burnetii infection depends on both the virulence of the infecting C. burnetii strain and specific risks factors in the infected patient. Moreover, no persistent infection can exist without a focus of infection. This paradigm change should allow better diagnosis and management of primary infection and long-term complications in patients with C. burnetii infection.

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“…One study determined the prevalence of CFS in patients with Q fever compared to a healthy control group. In both groups only one patient met these criteria, although a substantial proportion of the patients with Q fever was chronically fatigued [12].…”

Section: Introductionmentioning

confidence: 98%

A comparison of patients with Q fever fatigue syndrome and patients with chronic fatigue syndrome with a focus on inflammatory markers and possible fatigue perpetuating cognitions and behaviour

Keijmel

Saxe

Meer

et al. 2015

Journal of Psychosomatic Research

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Are fatigue symptoms and chronic fatigue syndrome following Q fever infection related to psychosocial variables?

Cited by 12 publications

References 43 publications

Effectiveness of Long-term Doxycycline Treatment and Cognitive-Behavioral Therapy on Fatigue Severity in Patients with Q Fever Fatigue Syndrome (Qure Study): A Randomized Controlled Trial

Effectiveness of Long-term Doxycycline Treatment and Cognitive-Behavioral Therapy on Fatigue Severity in Patients with Q Fever Fatigue Syndrome (Qure Study): A Randomized Controlled Trial

From Q Fever to Coxiella burnetii Infection: a Paradigm Change

A comparison of patients with Q fever fatigue syndrome and patients with chronic fatigue syndrome with a focus on inflammatory markers and possible fatigue perpetuating cognitions and behaviour

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