title: [Outbreak of Coxiella burnetii pneumonia].
abstract: OBJECTIVE
  The aim of this study was to describe an outbreak of Q fever pneumonia in the North of Spain.
  
  
  METHODS
  We report 60 cases of Coxiella burnetii pneumonia in a rural area with 16,000 inhabitants during January and February 2003. The diagnosis was serologically confirmed by indirect immunofluorescence.
  
  
  RESULTS
  Mean age of the patients was 46 years and the male/female ratio was 2.5. Overall, 52% of the patients lived in urbanized areas and contact with animals was declared in only 7% of patients. Sixty percent of patients were hospitalized. The most frequent clinical presentation was an acute febrile process (100%) and headache (80%); respiratory symptoms were infrequent. The most common liver function alteration was elevated transaminase levels (35%). Radiologic evidence of a single lobar or segmental alveolar opacity was found in 87% of patients, and most commonly affected the lower lobes. Chest radiographs returned to normal in 70% of patients within the two first months. Empirical treatment consisted of beta-lactams and macrolides in 38%, macrolides alone in 8%, and quinolones in 23%; 27% were treated with beta-lactams alone. No deaths occurred.
  
  
  CONCLUSIONS
  Coxiella burnetii infection is very prevalent in the north of Spain and should be suspected and investigated when outbreaks of a pneumonic illness occur.
authors.affiliation: Sección de Neumología, Hospital Alvarez-Buylla, Mieres, España. mgclemen@telefonica.net
authors.forename: Marta
authors.initials: M
authors.lastname: García-Clemente
authors.forename: Ana José
authors.initials: AJ
authors.lastname: Seco-García
authors.forename: Margarita
authors.initials: M
authors.lastname: Gutiérrez-Rodríguez
authors.forename: Pedro
authors.initials: P
authors.lastname: Romero-Alvarez
authors.forename: Julio
authors.initials: J
authors.lastname: Fernández-Bustamante
authors.forename: Mercedes
authors.initials: M
authors.lastname: Rodríguez-Pérez
mesh_terms: D000328:Adult; D000818:Animals; D000829:Animals, Domestic / Q000382:microbiology; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000635:transmission; D016997:Coxiella burnetii / Q000302:isolation & purification*; D004196:Disease Outbreaks; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D011778:Q Fever / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D012189:Retrospective Studies; D012424:Rural Population; D013030:Spain / Q000453:epidemiology; D015047:Zoonoses