title: Travel-associated Coxiella burnetii infections: three cases of Q fever with different clinical manifestation.
abstract: BACKGROUND
  Certain activities expose travellers to Coxiella burnetii, the causative agent of acute human Q fever. Awareness of Q fever must be improved, also as a potential imported disease, but delayed seroconversion and serological cross-reactivity complicate the diagnosis. Granulomatous inflammation of liver and bone marrow can be typical histopathological findings.
  
  
  METHODS
  We present three imported cases of Q fever with different clinical presentations, in which the travel history identified the sources of infection.
  
  
  CONCLUSIONS
  Q fever should be suspected in any imported febrile disease of unknown origin. Clinical manifestations are variable and repeated serological testing is mandatory. In some cases diagnostic biopsies might help to establish early diagnosis.
authors.affiliation: Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Bernhard Nocht Str 74, D-20359 Hamburg, Germany. kobbe@bni-hamburg.de
authors.forename: Robin
authors.initials: R
authors.lastname: Kobbe
authors.forename: Stefanie
authors.initials: S
authors.lastname: Kramme
authors.forename: Andreas
authors.initials: A
authors.lastname: Gocht
authors.forename: Mathias
authors.initials: M
authors.lastname: Werner
authors.forename: Ute
authors.initials: U
authors.lastname: Lippert
authors.forename: Jürgen
authors.initials: J
authors.lastname: May
authors.forename: Gerd
authors.initials: G
authors.lastname: Burchard
mesh_terms: D000328:Adult; D000818:Animals; D002162:Camelus; D002417:Cattle; D016997:Coxiella burnetii / Q000302:isolation & purification*; D005334:Fever / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011778:Q Fever / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D014195:Travel; D015047:Zoonoses / Q000382:microbiology