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Clinical and Genetic Features of Coxiella burnetii in a Patient with an Acute Febrile Illness in Korea.

ABSTRACT: Although Q fever is an important zoonotic infection with a worldwide distribution, no human isolates of Coxiella burnetii have been identified in Korea. For the first time, we identified the nucleotide sequence of C. burnetii from a 32-year-old man with an acute febrile illness in Korea. Diagnosis of acute Q fever was confirmed by seroconversion using indirect immunofluorescence antibody assays. Phylogenetic analysis demonstrated high sequence similarity (99.6%-100%) with C. burnetii 16S rRNA sequences identified from the reservoir. These results are the first genetic analysis of C. burnetii in a human case of Q fever in Korea.

SUBMITTER: Lee SH

PROVIDER: S-EPMC5426248 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Clinical and Genetic Features of Coxiella burnetii in a Patient with an Acute Febrile Illness in Korea.

Lee Seung Hun SH Heo Jung Yeon JY Lee Hae Kyung HK Lee Yeong Seon YS Jeong Hye Won HW Hwang Seon Do SD

Journal of Korean medical science 20170601 6

Although Q fever is an important zoonotic infection with a worldwide distribution, no human isolates of Coxiella burnetii have been identified in Korea. For the first time, we identified the nucleotide sequence of C. burnetii from a 32-year-old man with an acute febrile illness in Korea. Diagnosis of acute Q fever was confirmed by seroconversion using indirect immunofluorescence antibody assays. Phylogenetic analysis demonstrated high sequence similarity (99.6%-100%) with C. burnetii 16S rRNA se ...[more]

PMID: 28480664

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Project description:ImportanceQ fever remains widespread throughout the world; the disease is serious and causes outbreaks and deaths when complications are not detected. The diagnosis of Q fever requires the demonstration of the presence of Coxiella burnetii and the identification of an organic lesion.ObjectiveTo describe the hitherto neglected clinical characteristics of Q fever and identifying risk factors for complications and death.Design, setting, and participantsThis prospective cohort study conducted from January 1, 1991, through December 31, 2016, included patients treated at the French National Reference Center for Q fever with serologic findings positive for C burnetii and clinical data consistent with C burnetii infection. Clinical data were prospectively collected by telephone. Patients with unavailable clinical data or an unidentified infectious focus were excluded.Main outcomes and measuresQ fever complications and mortality.ResultsOf the 180?483 patients undergoing testing, 2918 had positive findings for C burnetii and 2434 (68.8% men) presented with clinical data consistent with a C burnetii infection. Mean (SD) age was 51.8 (17.4) years, and the ratio of men to women was 2.2. At the time of inclusion, 1806 patients presented with acute Q fever, including 138 with acute Q fever that progressed to persistent C burnetii infection, and 766 had persistent focalized C burnetii infection. Rare and hitherto neglected foci of infections included lymphadenitis (97 [4.0%]), acute Q fever endocarditis (50 [2.1%]), hemophagocytic syndrome (9 [0.4%]), and alithiasic cholecystitis (11 [0.4%]). Vascular infection (hazard ratio [HR],?3.1; 95% CI, 1.7-5.7; P?<?.001) and endocarditis (HR,?2.4; 95% CI, 1.1-5.1; P?=?.02) were associated with an increased risk of death. Independent indicators of lymphoma were lymphadenitis (HR,?77.4; 95% CI, 21.2-281.8; P?<?.001) and hemophagocytic syndrome (HR,?19.1; 95% CI, 3.4-108.6; P?<?.001). The presence of anticardiolipin antibodies during acute Q fever has been associated with several complications, including hepatitis, cholecystitis, endocarditis, thrombosis, hemophagocytic syndrome, meningitis, and progression to persistent endocarditis.Conclusions and relevancePreviously neglected foci of C burnetii infection include the lymphatic system (ie, bone marrow, lymphadenitis) with a risk of lymphoma. Cardiovascular infections were the main fatal complications, highlighting the importance of routine screening for valvular heart disease and vascular anomalies during acute Q fever. Routine screening for anticardiolopin antibodies during acute Q fever can help prevent complications. Positron emission tomographic scanning could be proposed for all patients with suspected persistent focused infection to rapidly diagnose vascular and lymphatic infections associated with death and lymphoma, respectively.

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Clinical and Genetic Features of Coxiella burnetii in a Patient with an Acute Febrile Illness in Korea.

Publications

Clinical and Genetic Features of Coxiella burnetii in a Patient with an Acute Febrile Illness in Korea.

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