Severe acute Q fever pneumonia complicated by presumed persistent localized Q fever endocarditis in a renal transplant recipient: A case report and review of the literature

Budgin, Angela M.; Abidi, Maheen Z.; Bajrovic, Valida; Miller, Matthew A.; Johnson, Steven C.

doi:10.1111/tid.13230

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…Most acute Q fever cases are asymptomatic, but patients may also present with constitutional signs and symptoms, thus making accurate diagnosis difficult [120]. Furthermore, although rare (1-5% of cases), chronic complications after primary infection may occur, including interstitial fibrosis, hepatitis, encephalitis, endocarditis, and valvular pathology [121,122].…”

Section: Coxiella Burnetiimentioning

confidence: 99%

Pattern Recognition Receptors in Innate Immunity to Obligate Intracellular Bacteria

et al. 2021

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Host pattern recognition receptors (PRRs) are crucial for sensing pathogenic microorganisms, initiating innate responses, and modulating pathogen-specific adaptive immunity during infection. Rickettsia spp., Orientia tsutsugamushi, Anaplasma spp., Ehrlichia spp., and Coxiella burnetii are obligate intracellular bacteria that can replicate only within host cells and must evade immune detection to successfully propagate. These five bacterial species are zoonotic pathogens of clinical or agricultural importance, yet uncovering how immune recognition occurs has remained challenging. Recent evidence from in vitro studies and animal models has yielded new insights into the types and kinetics of PRR activation during infection with Rickettsia spp., A. phagocytophilum, E. chaffeensis, and C. burnetii. However, much less was known about PRR activation in O. tsutsugamushi infection until the recent discovery of the role of the C-type lectin receptor Mincle during lethal infection in mice and in primary macrophage cultures. This review provides a brief summary of the clinical and epidemiologic features of these five bacterial infections, with a focus on the fundamental biologic facets of infection, and recent advances in host recognition. In addition, knowledge gaps regarding the innate recognition of these bacteria in the context of disease pathogenesis are discussed.

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Section: Coxiella Burnetiimentioning

confidence: 99%

Pattern Recognition Receptors in Innate Immunity to Obligate Intracellular Bacteria

et al. 2021

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“…In humans, the typical clinical symptoms of acute Q fever are influenza-like manifestations, including hyperpyrexia, chills, and severe headache (8,9). Critical patients often present with pneumonia, granulomatous hepatitis, heart damage, neurological symptoms, and so on (10). If the treatment is not timely, about 5% of acute patients could turn to chronic Q fever, which can be manifested as endocarditis, chronic hepatitis, vascular infections, or osteomyelitis, increasing the difficulty of cure (11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Case Report: Metagenomic Next-Generation Sequencing Clinches the Diagnosis of Acute Q Fever and Verified by Indirect Immunofluorescence Assay

et al. 2022

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Q fever is a zoonotic infectious disease caused by Coxiella burnetii. The clinical symptoms of acute Q fever are usually atypical, and routine serological tests of C. burnetii are not readily available, making the diagnosis of Q fever a challenge. In this case, we report a male patient who had repeated fevers and was administered empirical anti-infective treatment, but the effect was poor. After conducting relevant laboratory and imagological examinations, the etiology has not yet been confirmed. Subsequently, metagenomic next-generation sequencing (mNGS) identified the sequence reads of C. burnetii from the patient's peripheral blood within 48 h, and then the diagnosis of acute Q fever was established. Moreover, the serological test of indirect immunofluorescence assay (IFA) of the C. burnetii antibody was further performed in the Centers for Disease Control, certifying the result of mNGS. The patient was ultimately treated with doxycycline and recovered well. mNGS is an unbiased and comprehensive method in infrequent or culture-negative pathogen identification. To our knowledge, this is the first case of acute Q fever identified by mNGS and confirmed by IFA in Taizhou, China. A further large-scale prospective clinical cohort study is worth carrying out to compare the diagnostic efficiency of mNGS with traditional serological methods and PCR in acute Q fever.

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“… 10 Humans usually contract the disease by inhaling contaminated aerosols emitted from infected livestock. 11 The main clinical manifestations are fever with chills, headache, muscle aches, and fatigue. Antibiotic treatment is effective in the early stage of the disease.…”

Section: Introductionmentioning

confidence: 99%

Epidemiological Characteristics and Clinical Manifestations of Brucellosis and Q Fever Among Humans from Northeastern Inner Mongolia

Ta¹,

Mi²,

Li³

et al. 2022

IDR

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To investigate the distribution, epidemiology, and clinical symptoms of brucellosis and Q fever in northeastern Inner Mongolia. Methods: In this study, 64 townships of Bairin left flag and Alukerqin flag, Jarud flag and Horqin right front flag in four counties with frequent brucellosis and Q fever were selected. Epidemiological characteristics, clinical features, and exposure to risk factors were identified and descriptively analyzed in patients from these areas. Results: There were 367 brucellosis cases in the four regions and 78 positive cases of Q-fever infection. In addition, 24 cases of brucellosis and Q-fever co-infection were identified, with a co-infection rate of 1.13%. Brucellosis and Q fever were mainly concentrated in the 30-65 and 40-55 age groups. For brucellosis, the difference between age groups was statistically significant (χ 2 = 29.121, P < 0.05). The sex distribution for brucellosis was 225 men (61.31%) and 142 women (38.69%), and 45 men (57.69%) and 33 women (42.31%) had Q fever. Those with brucellosis and Q fever were mainly farmers, accounting for 79.19% and 78.38% of the total number, respectively. Of the 367 cases of brucellosis infection, the main symptoms were joint pain (52.59%), fatigue (47.14%), lower back pain (38.96%), fever (33.24%), hyperhidrosis (28.88%), and muscle pain (20.44%). Of the 78 cases of Q-fever infection, the main symptoms were joint pain (35.90%), fatigue (30.77%), lower back pain (26.92%), fever (21.79%), and hyperhidrosis (17.95%). Muscle pain also accounted for 12.82%. Conclusion:Occupational distribution suggests that we should strengthen the protection measures against diseases infected through animal husbandry. Among the clinical symptoms, fever, hyperhidrosis and fatigue were associated with brucellosis, while fever, headache, and fatigue were significantly associated with Q fever.

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Severe acute Q fever pneumonia complicated by presumed persistent localized Q fever endocarditis in a renal transplant recipient: A case report and review of the literature

Abstract: Q fever in solid organ transplant (SOT) recipients is rarely described in the medical literature. We present a case of severe acute Q fever pneumonia that evolved into persistent localized Q fever endocarditis in a renal transplant recipient.

Cited by 4 publications

References 16 publications

Pattern Recognition Receptors in Innate Immunity to Obligate Intracellular Bacteria

Pattern Recognition Receptors in Innate Immunity to Obligate Intracellular Bacteria

Case Report: Metagenomic Next-Generation Sequencing Clinches the Diagnosis of Acute Q Fever and Verified by Indirect Immunofluorescence Assay

Epidemiological Characteristics and Clinical Manifestations of Brucellosis and Q Fever Among Humans from Northeastern Inner Mongolia

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