title: Coxiella burnetii, the agent of Q fever in Brazil: its hidden role in seronegative arthritis and the importance of molecular diagnosis based on the repetitive element IS1111 associated with the transposase gene.
abstract: Coxiella burnetii is the agent of Q fever , an emergent worldwide zoonosis of wide clinical spectrum. Although C. burnetii infection is typically associated with acute infection, atypical pneumonia and flu-like symptoms, endocarditis, osteoarticular manifestations and severe disease are possible, especially when the patient has a suppressed immune system; however, these severe complications are typically neglected. This study reports the sequencing of the repetitive element IS1111 of the transposase gene of C. burnetii from blood and bronchoalveolar lavage (BAL) samples from a patient with severe pneumonia following methotrexate therapy, resulting in the molecular diagnosis of Q fever in a patient who had been diagnosed with active seronegative polyarthritis two years earlier. To the best of our knowledge, this represents the first documented case of the isolation of C. burnetii DNA from a BAL sample.
authors.affiliation: Laboratório de Hantaviroses e Rickettsioses, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, RJ, Brasil. rozental@ioc.fiocruz.br
authors.forename: Tatiana
authors.initials: T
authors.lastname: Rozental
authors.forename: Luis Filipe
authors.initials: LF
authors.lastname: Mascarenhas
authors.forename: Ronaldo
authors.initials: R
authors.lastname: Rozenbaum
authors.forename: Raphael
authors.initials: R
authors.lastname: Gomes
authors.forename: Grasiely Souza
authors.initials: GS
authors.lastname: Mattos
authors.forename: Cecília Carlos
authors.initials: CC
authors.lastname: Magno
authors.forename: Daniele Nunes
authors.initials: DN
authors.lastname: Almeida
authors.forename: Maria Inês Doria
authors.initials: MI
authors.lastname: Rossi
authors.forename: Alexsandra R M
authors.initials: AR
authors.lastname: Favacho
authors.forename: Elba Regina Sampaio
authors.initials: ER
authors.lastname: de Lemos
mesh_terms: D000208:Acute Disease; D000328:Adult; D001168:Arthritis / Q000382:microbiology*; D018893:Bronchoalveolar Lavage; D016997:Coxiella burnetii / Q000235:genetics* / Q000302:isolation & purification; D004269:DNA, Bacterial / Q000235:genetics*; D006801:Humans; D008297:Male; D011778:Q Fever / Q000175:diagnosis*; D012091:Repetitive Sequences, Nucleic Acid / Q000235:genetics*; D019895:Transposases / Q000235:genetics*
chemical_list: D004269:DNA, Bacterial; D019895:Transposases