Q fever during pregnancy: diagnosis, treatment, and follow-up.
BACKGROUND
Q fever, caused by Coxiella burnetii, may result in abortions, premature deliveries, and stillbirths in infected pregnant women.


OBJECTIVE
To evaluate the best treatment strategy for Q fever during pregnancy.


METHODS
We evaluated the prognosis of 17 pregnant women who developed Q fever with and without co-trimoxazole (trimethoprim-sulfamethoxazole) treatment.


RESULTS
The outcome of the pregnancy was found to depend on the trimester. Abortions occurred in 7 of 7 insufficiently treated patients infected during the first trimester vs 1 of 5 patients infected later. Co-trimoxazole given until delivery protected against abortion (0/4) but not against the development of chronic infections, and it did not significantly reduce the colonization of the placenta (2/4 vs 4/4).


CONCLUSIONS
Our results show that C burnetii infections cause abortion and that women who develop Q fever while pregnant should be treated with co-trimoxazole for the duration of pregnancy, specifically when infected during the first trimester.
Raoult
Didier
D
Unité des Rickettsies, Université de la Méditerranée, Faculté de Médecine, CNRS UMR 6020, 27 Boulevard Jean Moulin, 13385 Marseille CEDEX 05, France. Didier.Raoult@medecine.univ-mrs.fr
Fenollar
Florence
F
Stein
Andreas
A
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D016997:Coxiella burnetii / Q000302:isolation & purification; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011264:Pregnancy Trimesters / Q000187:drug effects; D011379:Prognosis; D011778:Q Fever / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy*; D012698:Serologic Tests; D013997:Time Factors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination