title: Acute Q fever in adult patients: report on 63 sporadic cases in an urban area.
abstract: We report here 63 sporadic urban cases of acute Q fever diagnosed in 1985-1997. Fifty-eight men and five women were included; the mean age (+/- SD) was 35.6 (+/- 10.2) years. Twenty-six patients had pneumonia, 30 had hepatitis, and 7 had a self-limited febrile illness. The most frequent radiological abnormalities were lobar or segmental alveolar opacities involving right lower lobes. Chronic bronchitis was significantly more frequent among patients with pneumonic Q fever (P = .01). Thirty-two patients' illnesses were diagnosed through seroconversion, 12 by a fourfold increase in serum antibody titer, and 19 by initial high titers. Patients who initially received doxycycline had a significantly shorter duration of fever than those treated with erythromycin or other antibiotics (P = .0001 and P = .0004, respectively). No patient died. Acute Q fever affects mainly urban men, most frequently causing hepatitis, except in those with chronic bronchitis, who more frequently develop pneumonia. Hepatic Q fever presented with more pronounced increases in liver function test values than did pneumonic Q fever. Treatment with doxycycline caused a significant reduction in the duration of fever.
authors.affiliation: Department of Internal Medicine, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Spain. pere.domingo@cc.uab.es
authors.forename: P
authors.initials: P
authors.lastname: Domingo
authors.forename: C
authors.initials: C
authors.lastname: Muñoz
authors.forename: T
authors.initials: T
authors.lastname: Franquet
authors.forename: M
authors.initials: M
authors.lastname: Gurguí
authors.forename: F
authors.initials: F
authors.lastname: Sancho
authors.forename: G
authors.initials: G
authors.lastname: Vazquez
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011778:Q Fever / Q000150:complications / Q000188:drug therapy*
chemical_list: D004318:Doxycycline