Chronic Q fever diagnosis— consensus guideline versus expert opinion
Chronic Q fever, caused by Coxiella burnetii, has high mortality and morbidity rates if left untreated. Controversy about the diagnosis of this complex disease has emerged recently. We applied the guideline from the Dutch Q Fever Consensus Group and a set of diagnostic criteria proposed by Didier Raoult to all 284 chronic Q fever patients included in the Dutch National Chronic Q Fever Database during 2006–2012. Of the patients who had proven cases of chronic Q fever by the Dutch guideline, 46 (30.5%)would not have received a diagnosis by the alternative criteria designed by Raoult, and 14 (4.9%) would have been considered to have possible chronic Q fever. Six patients with proven chronic Q fever died of related causes. Until results from future studies are available, by which current guidelines can be modified, we believe that the Dutch literature-based consensus guideline is more sensitive and easier to use in clinical practice.
Linda M
LM
Kampschreur
Marjolijn C A
MC
Wegdam-Blans
Peter C
PC
Wever
Nicole H M
NH
Renders
Corine E
CE
Delsing
Tom
T
Sprong
Marjo E E
ME
van Kasteren
Henk
H
Bijlmer
Daan
D
Notermans
Jan Jelrik
JJ
Oosterheert
Frans S
FS
Stals
Marrigje H
MH
Nabuurs-Franssen
Chantal P
CP
Bleeker-Rovers
D006801:Humans; D009426:Netherlands; D017410:Practice Guidelines as Topic; D011778:Q Fever / Q000175:diagnosis*