Fatigue following Acute Q-Fever: A Systematic Literature Review

Abstract

BackgroundLong-term fatigue with detrimental effects on daily functioning often occurs following acute Q-fever. Following the 2007–2010 Q-fever outbreak in the Netherlands with over 4000 notified cases, the emphasis on long-term consequences of Q-fever increased. The aim of this study was to provide an overview of all relevant available literature, and to identify knowledge gaps regarding the definition, diagnosis, background, description, aetiology, prevention, therapy, and prognosis, of fatigue following acute Q-fever.DesignA systematic review was conducted through searching Pubmed, Embase, and PsycInfo for relevant literature up to 26th May 2015. References of included articles were hand searched for additional documents, and included articles were quality assessed.ResultsFifty-seven articles were included and four documents classified as grey literature. The quality of most studies was low. The studies suggest that although most patients recover from fatigue within 6–12 months after acute Q-fever, approximately 20% remain chronically fatigued. Several names are used indicating fatigue following acute Q-fever, of which Q-fever fatigue syndrome (QFS) is most customary. Although QFS is described to occur frequently in many countries, a uniform definition is lacking. The studies report major health and work-related consequences, and is frequently accompanied by nonspecific complaints. There is no consensus with regard to aetiology, prevention, treatment, and prognosis.ConclusionsLong-term fatigue following acute Q-fever, generally referred to as QFS, has major health-related consequences. However, information on aetiology, prevention, treatment, and prognosis of QFS is underrepresented in the international literature. In order to facilitate comparison of findings, and as platform for future studies, a uniform definition and diagnostic work-up and uniform measurement tools for QFS are proposed.

Acute Pericarditis due to Coxiellaburnetiiinfection, a case report

“…However, other clinical manifestations may be observed, including hepatic, neurologic, dermatologic, and cardiac disturbs [11]. In case series, pericarditis has been observed in 1% of patients affected by C. burnetii infection.…”

Q fever: A rural disease with potential urban consequences

“…Other features of the chronic form include granulomatous hepatitis and osteomyelitis, which is more likely to occur in children. 26,27 Public health prevention, infection control and immunisation…”

Coxiella burnetiiseroprevalence in unvaccinated veterinary workers in Australia: Evidence to support Q fever vaccination

“…However, some Q fever patients experience severe symptoms including but not limited to pneumonia, hepatitis, obstetric complications including foetal death, and persistent endocardial, vascular and osteoarticular infections (Angelakis & Raoult, ; Carcopino, Raoult, Bretelle, Boubli, & Stein, ; Million & Raoult, , ). Post‐Q fever fatigue syndrome (QFS) is experienced by up to 20% of Q fever patients and may persist for years with debilitating consequences (Morroy et al, ).…”