Acute Q fever in Israel: clinical and laboratory study of 100 hospitalized patients.
BACKGROUND
Q fever is endemic in Israel, yet a large series describing the clinical spectrum of inpatients with acute Q fever in Israel is lacking.


OBJECTIVE
To report on the clinical characteristics and outcome of hospitalized patients with acute Q fever in Israel.


METHODS
We conducted a retrospective study of 100 patients hospitalized in six medical centers, in whom acute Q fever was diagnosed by the presence of immunoglobulin G and M antibodies to phase II Coxiella burnetti antigens.


RESULTS
The mean age of the patients was 42.7 +/- 17.3 years with a male to female ratio of 1.6:1. Acute Q fever occurred throughout the year but was more common during the warm season. The most common clinical presentation was acute febrile disease (98%, mean length of fever 15.5 +/- 8.6 days), followed by hepatitis (67%) and pneumonia (32%). The prominent laboratory findings included: accelerated erythrocyte sedimentation rate, normal or low white blood count with many band forms, thrombocytopenia, and abnormal urinalysis. Although the diagnosis of acute Q fever was not known during the hospitalization in the majority of patients, about 80% of our patients received appropriate antibiotic therapy and all patients recovered.


CONCLUSIONS
Patients with acute Q fever present with a typical clinical picture that enables clinical diagnosis and empiric therapy in most cases. The prognosis of hospitalized patients with acute Q fever is excellent.
Ergas
David
D
Department of Medicine B, Kaplan Medical Center, Rehovot, Israel.
Keysari
Avi
A
Edelstein
Victor
V
Sthoeger
Zev M
ZM
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D016997:Coxiella burnetii / Q000276:immunology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011778:Q Fever / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial