title: Q Fever Risk in Patients Treated with Chronic Antitumor Necrosis Factor-Alpha Therapy.
abstract: Q fever is a zoonotic bacterial disease caused by Coxiella burnetii. Tumor necrosis factor-alpha (TNF-α) plays a pivotal role in the defense against infection with this Gram-negative coccobacillus. Theoretically, patients who are treated with anti-TNF-α medications are at risk for developing chronic Q fever. We present two patients who developed Q fever while being treated with anti-TNF-α agents and discuss the significance of timely diagnosis of C. burnetii infection in these patients.
authors.affiliation: Bruce and Ruth Rappaport Faculty of Medicine, Technion, Haifa, Israel.
authors.forename: Julianna
authors.identifier: 0000-0003-2911-2113
authors.initials: J
authors.lastname: Hirsch
authors.affiliation: Department of Internal Medicine A, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Anna
authors.initials: A
authors.lastname: Astrahan
authors.affiliation: Bruce and Ruth Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Internal Medicine A, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Majed
authors.initials: M
authors.lastname: Odeh
authors.affiliation: Bruce and Ruth Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Internal Medicine A, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Nizar
authors.initials: N
authors.lastname: Elias
authors.affiliation: Bruce and Ruth Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Rheumatology, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Itzhak
authors.initials: I
authors.lastname: Rosner
authors.affiliation: Bruce and Ruth Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Rheumatology, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Rimar
authors.affiliation: Bruce and Ruth Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Rheumatology, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Lisa
authors.initials: L
authors.lastname: Kaly
authors.affiliation: Bruce and Ruth Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Rheumatology, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Rozenbaum
authors.affiliation: Bruce and Ruth Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Rheumatology, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Nina
authors.initials: N
authors.lastname: Boulman
authors.affiliation: Bruce and Ruth Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Rheumatology, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Gleb
authors.initials: G
authors.lastname: Slobodin