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[Growth of Coxiella burnetii in selected cell cultures].

Usefulness of monolayer cell cultures for C. burnetii multiplication was evaluated. Continuous Vero cell line and primary cell (cultures cell culture of monkey kidney Cercopithecus aethiops, cell culture of chicken fibroblasts, diploid cell line of human embryo) was inoculated for this purpose. Two Coxiella burnetii strains suspensions were used as inoculum of standard Henzerling strain and Zamość strain isolated from an area of Poland. Primary cell lines were characterized by considerable degree of sensitivity to, C. burnetii infection, and at the same time, the most sensitive was the line derived from monkey kidney. Progressive vacuolisation of infected culture cells was designated as cytopathic effect. Henzerling strain showed higher infectivity (4.7 x 10(8) PFU/ml) for chicken fibroblasts as compared to Zamość strain (8.7 x 10(6) PFU/ml). On the other hand both strains induced cytopathic effect in Vero cell line without degeneration of host cells.

Animals↗

Immunoglobulin responses to Coxiella burnetii (Q fever): single-serum diagnosis of acute infection, using an immunofluorescence technique.

Blood specimens were collected over various periods of time from 30 abattoir workers with a clinical diagnosis of Q fever. All specimens were tested for complement-fixing antibodies and for specific immunoglobulin M (IgM) globulins to phase 1 and 2 Coxiella burnetii organisms by an immunofluorescence technique. All 22 patients with increasing levels of complement-fixing antibodies were shown to have generated specific IgM globulins, as did 4 patients with high convalescent titers but from whom "acute" specimens were not collected. Four individuals who did not show increasing levels of complement-fixing antibodies did not produce measurable levels of specific IgM. All patients with Q fever gave positive specific IgM results by 2 weeks after the onset of symptoms. IgM to phase 1 antigen persisted for 27 weeks in one patient, but IgM to phase 2 antigen was not detectable beyond 17 weeks. The estimation of Q fever-specific IgM has proved useful in confirming infection when only a "convalescent" blood specimen is available.

Abattoirs↗

Acute glomerulonephritis associated with acute Q fever: case report and review of the renal complications of Coxiella burnetii infection.

We report a case of acute glomerulonephritis associated with acute Q fever. An abattoir worker with a nonspecific febrile illness and pneumonia and abnormal liver function test results developed hematuria, proteinuria, and acute renal failure that resolved with appropriate antimicrobial therapy. Renal biopsy demonstrated diffuse proliferative and exudative glomerulonephritis. Serological tests confirmed recent infection with Coxiella burnetii, with a fourfold rise in the titer of phase II antibody, positive phase II IgM antibody, and negative phase I antibody. Other known causes of glomerulonephritis were excluded. Most reports of renal complications of C. burnetii infection describe glomerulonephritis associated with endocarditis due to chronic Q fever. Renal involvement in patients with acute C. burnetii infection has been rarely described. Glomerulonephritis should be recognized as a complication of acute C. burnetii infection and endocarditis due to chronic Q fever.

Acute Disease↗

Poikilotherms as reservoirs of Q-fever (Coxiella burnetii) in Uttar Pradesh.

Water snakes (Natrix natrix), rat snakes (Ptyas korros), cobras (Naja naja), pythons (Python molurus), tortoises (Kachuga sp.), plankton fish (Cirrhina mrigala), frogs (Rana tigrina), toads (Bufo sp.) and monitors (Varanus indicus) were screened for evidence of Q-fever infection by the capillary agglutination test on sera to detect antibodies and/or by attempts to demonstrate Coxiella burnetii in spleen and liver samples. Sero-reactors were observed among water and rat snakes, pythons and tortoises. The organism was isolated from the spleen and liver of the monitor, tortoise and python.

Amphibians↗

Chronic sternal wound infection and endocarditis with Coxiella burnetii.

Chronic Q fever is most commonly associated with culture-negative endocarditis and less frequently with infection of vascular grafts, infection of aneurysms, hepatitis, pulmonary disease, osteomyelitis, and neurological abnormalities. We report a case of chronic sternal wound infection, polyclonal gammopathy, and mixed cryoglobulinemia in which Q fever endocarditis was subsequently diagnosed. Polymerase chain reaction analysis of the wound tissue was positive for Coxiella burnetii DNA, and treatment of the endocarditis resulted in prompt healing of the wound. Chronic Q fever can occur without epidemiological risk factors for C. burnetii exposure and can produce multisystem inflammatory dysfunction, aberrations of the immune system, and persistent wound infections.

Aged↗

A rickettsia-like organism showing positive immunofluorescence with antisera to Coxiella burnetii in Haemaphysalis inermis ticks.

A rickettsia-like organism (RLO) was detected in the oocytes of Haemaphysalis inermis ticks. The RLOs were about 5 microns long bent rods with a definite inner structure. They were Gram-negative and could be visualized by Giemsa but not by Gimenez staining. Attempts to cultivate the RLO in chick embryo yolk sacs, various types of cell culture and tick body cavities were unsuccessful. The RLO displayed a bright immunofluorescence with antisera to Coxiella burnetii, but no immunofluorescence was obtained with antisera to representatives of typhus and spotted fever group rickettsiae, with the exception of very weak fluorescence with serum from a rabbit immunized with Rickettsia akari and one serum from Apodemus flavicollis immunized with Rickettsia conorii. These findings should be taken into consideration when studying the infestation of ticks with rickettsiae.

Animals↗

[Coxiella burnetii osteoarthritis].

A case of a 25-year-old female characterized by febrile osteoarthritis and arthromyalgias as the only clinical manifestation of a Q fever is discussed. Analytical data were compatible with those of an acute inflammation and serologic findings reached diagnostic levels. Response to Doxycycline treatment was totally satisfactory. Even though associated arthromyalgias are described in some cases of Q fever as well as sporadic cases of osteoarthal infection due to Coxiella burnetii, there are no oligosymptomatic cases published as the one discussed. Some physiopathologic considerations referred to this peculiar onset are suggested.

Acute Disease↗

Monoclonal antibody based competitive ELISA for the detection of specific antibodies against Coxiella burnetii in sera from different animal species.

A competitive ELISA system for the detection of antibodies against Coxiella (C.) burnetii in cattle, sheep, goats, horses and humans is described. The ELISA is based on a biotinylated monoclonal antibody with specificity for C. burnetii lipopolysaccharide in combination with streptavidin peroxidase. For evaluation and statistical analysis, 413 sera from cattle, sheep, goats, horses and humans were tested in parallel in the indirect immunofluorescence test (IFT). Furthermore, a total of 448 bovine and human sera were also tested with an indirect ELISA and 47 sheep sera were investigated using the commercially available "Ridascreen AK EIA". Sensitivity and specificity values for the competitive ELISA described and determined with the aid of the indirect immunofluorescence test (IFT) as reference were: cattle, 88% and 89%; sheep, 100% and 93%, goat, 82% and 96%, horse 100% and 93%, and man 42% and 96%, respectively.

Animals↗

[Coxiella burnetii pneumopathy on return from French Guiana].

Q fever is a worldwide zoonosis but is not often a common cause of fever among travellers returning from the tropics. We report a case of acute Q fever, revealed by a pneumonia and acquired by a traveller in French Guyana. The chest radiography showed alveolar opacities and pleural effusion. Biological abnormalities were elevated liver enzyme levels and thrombocytopenia. The patient improved or the third day of antibiotic treatment. She mentioned that 3 other people she lived with during her trip had been diagnosed with Q fever. A common source outbreak was then suspected. They all stayed in the same farm in French Guyana. Animal exposure occurred there, in particular with a goat and a dog (both were parturient). The disease was probably transmitted by airborne dust to our patient, as no other vectors of transmission were found. Since the clinical presentation of Q fever is not specific, in order for the physician to diagnose it, he must have an awareness of the disease. Our case emphasised that looking for risk factors of Coxiella burnetii exposures is particularly important. Amongst them, the most important seems to be contact with farm animals. The clinician should thus try to trace such a possible contact when treating a case of traveler's Q fever.

Adult↗

Severe disease in a dairy herd associated with acute infection with bovine virus diarrhoea virus, Leptospira harjo and Coxiella burnetii.

Between November 1984 and February 1985, a serious outbreak of pyrexia, diarrhoea, agalactia, metritis and severe weight loss affected most of the recently calved cows in a 183-cow dairy herd in Norfolk. Fifteen cows died and 20 were culled. Forty cows aborted during or after the outbreak, and many of them produced mummified fetuses; 18 calves were stillborn and three others died soon after birth. Necropsy of three affected cows revealed ulceration of the gastrointestinal tract similar to that seen in cases of mucosal disease. Bovine virus diarrhoea virus was isolated from the intestines of one cow that died soon after the onset of illness. The virus was also isolated from the blood of four acutely ill cows and seroconversion was demonstrated in three of those that survived. The virus was isolated from three aborted fetuses, a stillborn calf and a live neonatal calf. Body fluids from two aborted fetuses were seropositive for the virus as were sera from all the aborting cows tested. In addition to widespread seroconversion to bovine virus diarrhoea virus during the outbreak, there was serological evidence of recent infection with Leptospira interrogans serovar hardjo and Coxiella burnetii in a high proportion of cows. It was concluded that this was primarily an acute outbreak of bovine virus diarrhoea but its unprecedented clinical severity was probably associated with the concurrent introduction of L hardjo and C burnetii into an immunologically naive herd during the main calving period. Epidemiological analysis suggested that the source of the virus and L hardjo was down-calving heifers returning from communal marsh grazing.

Abortion, Veterinary↗