title: Differentiation of Acute Q Fever from Other Infections in Patients Presenting to Hospitals, the Netherlands
abstract: Differentiating acute Q fever from infections caused by other pathogens is essential. We conducted a retrospective case-control study to evaluate differences in clinical signs, symptoms, and outcomes for 82 patients with acute Q fever and 52 control patients who had pneumonia, fever and lower respiratory tract symptoms, or fever and hepatitis, but had negative serologic results for Q fever. Patients with acute Q fever were younger and had higher C-reactive protein levels but lower leukocyte counts. However, a large overlap was found. In patients with an indication for prophylaxis, chronic Q fever did not develop after patients received prophylaxis but did develop in 50% of patients who did not receive prophylaxis. Differentiating acute Q fever from other respiratory infections, fever, or hepatitis is not possible without serologic testing or PCR. If risk factors for chronic Q fever are present, prophylactic treatment is advised.
authors.forename: Stephan P
authors.initials: SP
authors.lastname: Keijmel
authors.forename: Elmer
authors.initials: E
authors.lastname: Krijger
authors.forename: Corine E
authors.initials: CE
authors.lastname: Delsing
authors.forename: Tom
authors.initials: T
authors.lastname: Sprong
authors.forename: Marrigje H
authors.initials: MH
authors.lastname: Nabuurs-Franssen
authors.forename: Chantal P
authors.initials: CP
authors.lastname: Bleeker-Rovers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D005335:Fever of Unknown Origin / Q000175:diagnosis* / Q000453:epidemiology; D006761:Hospitals / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011778:Q Fever / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D012307:Risk Factors
keywords: Coxiella burnetii; Q fever; acute Q fever; bacteria; case–control study; chronic Q fever; clinical practice; hospital; prophylactic treatment; prophylaxis; the Netherlands