Current laboratory diagnosis of Q fever.
Q fever is a worldwide zoonosis caused by the strictly intracellular bacterium Coxiella burnetii. Among symptomatic patients (one-half of patients remain asymptomatic), acute Q fever most frequently manifests as a self-limited febrile illness, pneumonia, or hepatitis. Endocarditis is the predominant form of chronic Q fever. All the classical techniques of bacteriology may be used for diagnosis of C burnetii infection. Nonetheless, because of the risk of contamination, isolation must be performed in biosafety level 3 laboratories. Moreover, to date no diagnostic tests for detection by polymerase chain reaction or specific antibodies for immunochemistry are available commercially. Hence, Q fever is diagnosed in most cases by serology. The most reliable technique appears to be micro-immunofluorescence, which exhibits both good sensitivity and specificity. A wider use of this serology in cases of blood culture-negative endocarditis, atypical pneumonia, unexplained fever, and hepatitis should lead to an increase of diagnosed cases.
Scola
Bernard La
BL
Unité des Rickettsies, CNRS UMR 6020, Faculté de Médecine de Marseille, Marseille, France. bernard.lascola@medecine.univ-mrs.fr
D000818:Animals; D000829:Animals, Domestic; D016997:Coxiella burnetii / Q000472:pathogenicity; D003470:Culture Media; D006801:Humans; D007150:Immunohistochemistry; D051379:Mice; D016133:Polymerase Chain Reaction / Q000379:methods; D011778:Q Fever / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D012698:Serologic Tests / Q000145:classification
D003470:Culture Media