title: Q fever: epidemiology, clinical features and prognosis. A study from 1983 to 1999 in the South of Spain.
abstract: OBJECTIVE
  Clinical polymorphism is a main feature of Q fever and, depending upon the geographic location, differences in its clinical picture have been described. The objective of this study was to determine the epidemiology, clinical features and prognosis of acute Q fever in our area.
  
  
  METHODS
  From 1985 to 1999, consecutive cases of Q fever, presented as febrile syndrome and attended in a tertiary teaching hospital in Sevilla, Spain, were included and followed prospectively.
  
  
  RESULTS
  Two hundred and thirty-one cases of acute Q fever were included. A non-focalized febrile syndrome lasting from 7 to 28 days (fever of intermediate duration) was the most frequent presentation (n=208, 90%). One hundred and forty-eight patients had hepatitis. Overall, 53% of the cases were urban and contact with animals was referred in 39% of the patients. No relationship between clinical presentation and possible route of infection was observed. Prognosis was excellent (100% cured), although in 18 patients fever was prolonged more than 28 days and three patients developed life-threatening organ affection. Antimicrobial treatment was more effective if it was administered in the first two weeks (median defervescence of fever: 3 days versus 5.5 days, p<0.01).
  
  
  CONCLUSIONS
  Acute Q fever is a common cause of fever of intermediate duration, even in urban areas. Elevation of hepatic enzymes was the most frequent laboratory finding. Severe organ affection is uncommon and the overall prognosis of the disease is excellent. Early treatment seems to shorten the duration of the disease.
authors.affiliation: Service of Infectious Diseases, University Hospitals Virgen del Rocío, Sevilla, Spain. aristide@cica.es
authors.forename: Arístides de
authors.initials: Ad
authors.lastname: Alarcón
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Villanueva
authors.forename: Pompeyo
authors.initials: P
authors.lastname: Viciana
authors.forename: Luis
authors.initials: L
authors.lastname: López-Cortés
authors.forename: Rafael
authors.initials: R
authors.lastname: Torronteras
authors.forename: Máximo
authors.initials: M
authors.lastname: Bernabeu
authors.forename: Elisa
authors.initials: E
authors.lastname: Cordero
authors.forename: Jerónimo
authors.initials: J
authors.lastname: Pachón
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011778:Q Fever / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D018709:Statistics, Nonparametric; D014505:Urban Population