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PubMed2006

[Endocarditis caused by Coxilla burnetii].

Q-fever is antropozoonosis caused by Coxiella burnetii. The microorganism usually transmitted to humans through the inhalation of infected dust from sub clinical infected mammals. The most common reservoirs for Coxiella burnetii are large numbers domestic and wild animals. The illness can occur by farmers or slaughterhouses, or veterinarian and laboratories workers. In this report we presented case of endocarditic caused by Coxiella burnetii. The patient is driver 43 years old, who lived in the countryside Nahorevo. He hospitalized in May, 2002. He had symptoms of hepatitis, with elevation of transaminases in sera. Endocarditic was diagnosed by echosonografy. The patient is controlled by infectologist, cardiologist by cardio-surgeon, but since disease is in progress and operation treatment will be probably necessary.

Endocarditis, Subacute Bacterial↗

PubMed2005

Molecular and biological characterization of a novel Coxiella-like agent from Carios capensis.

The genus Coxiella is currently defined by a single monotypic species, Coxiella burnetii. Novel Coxiella spp. have been detected in ticks throughout the world. These bacteria have not been cultured or named, and their evolutionary relationships to C. burnetii are poorly known. A novel Coxiella-like agent was detected by PCR amplification and sequencing of DNA extracted from 64 pelican ticks, Carios capensis, from Devoux Bank, South Carolina, USA. PCR was used to amplify and characterize genes from the new bacterium. Sequences from some metabolic and housekeeping genes shared a 92-98% similarity to C. burnetii, but other genes such as the IS1111 transposon, com1, and 5S and 16S rRNA genes were not amplified by conventional PCR. Transovarial and transtadial transmission and environmental shedding of the agent were detected by PCR.

Animals↗

PubMed2003

Acute acalculous cholecystitis associated with Q fever: report of seven cases and review of the literature.

Q fever is a worldwide-occurring zoonosis caused by Coxiella burnetii. There are various clinical manifestations of acute Q fever, of which acute cholecystitis is a very rare clinical presentation. This study reports seven cases of acute cholecystitis associated with Coxiella burnetii and reviews two other cases from the literature. All patients were admitted to hospital for fever and abdominal pain in the right upper quadrant. Abdominal echography showed a distended gallbladder with biliary sludge without concrements in eight cases and with a single stone in one case. Diagnosis was made by specific serological investigation (microimmunofluorescence assay) for Coxiella burnetii. All nine patients were cured, six after laparoscopic cholecystectomy and three with antibiotics only. Histological examination of the gallbladders showed inflammation in five cases, although Coxiella burnetii was not detected by immunohistochemistry. The results show that laboratory investigations in patients admitted to hospital for symptoms consistent with acute acalculous cholecystitis should include a systematic search for Coxiella burnetii.

Acute Disease↗

PubMed1992

Reactivation of Q fever following cardiac surgery.

To determine whether reactivation of Q fever occurs following cardiac surgery 43 patients who had antibodies to Coxiella burnetii were identified pre-operatively. Serum samples were collected 1, 4 to 6, and 24 weeks post-operatively. One patient had active Q fever endocarditis. Seven of the remaining 42 (17%) had a > or = fourfold rise in titres for antibodies to Coxiella burnetii post-operatively. Only two of these seven had an increase in antibody titres for other agents suggesting that the fourfold titre rise for Coxiella burnetii was not part of a polyclonal response. It is concluded that self-limited reactivation of infection may occur among Coxiella burnetii seropositive patients undergoing open heart surgery.

Aged↗

PubMed1995

Validation of an enzyme immunoassay for serodiagnosis of acute Q fever.

An enzyme immunoassay was validated for the serodiagnosis of acute Q fever. Minimum positive tests were determined for both serial dilutions and a single dilution of patient sera. To establish the specificity of the test, 152 serum samples were tested from individuals with no evidence of past Coxiella burnetii infection. Diagnostic titers were set at > or = 128 for the IgM and IgG responses to phase I, at > or = 512 for the IgM response to phase II and at > or = 1,024 for the IgG response to phase II Coxiella burnetii. These titers gave a false-positive rate of < or = 1%. Alternatively, testing a single dilution of sera (1:128) gave specificities ranging from 97.3 to 98.7%. Tests with the greatest sensitivities, using serially diluted early convalescent-phase sera, were the IgM (84%) and IgG (80%) responses to phase II Coxiella burnetii. At a single serum dilution, 92% of early convalescent sera had a positive IgG response to phase II Coxiella burnetii. With a high specificity and good sensitivity, the EIA can be used to diagnose acute Q fever with a single convalescent serum specimen. The duration of a positive response was greater than five years.

Coxiella burnetii↗

PubMed1989

Approaches to the molecular epidemiology of rickettsioses.

This review deals with the developments of molecular approaches to the investigation of rickettsial disease epidemiology. The data presented include changes in the incidence and geographic distribution of endemic rickettsioses. Use of the DNA restriction enzyme technique, in combination with DNA probe analysis, for the molecular genetic differentiation of tick spotted fever--and typhus fever--group rickettsiae and correlation between with the analysis of polypeptide composition of the above group of rickettsiae are discussed. The data are presented on progress in the identification of various Coxiella burnetii strains as a result of restriction analysis of plasmid DNA as well as chromosomal DNA in combination with DNA probe. New and detailed characteristics of classified and newly isolated strains of rickettsiae and Coxiella burnetii revealed by molecular genetic differentiation techniques are discussed. New identification techniques using DNA probes in combination with restriction analysis of chromosomal from rickettsiae and both plasmid and chromosomal DNA from Coxiella burnetii are considered to have good prospects for future use in epidemiological assessment. The establishment of reference file banks containing restriction endonuclease data on the available typical and atypical strains of rickettsiae and Coxiella burnetii is suggested.

Animals↗

PubMed1986

Serological diagnosis of Q fever endocarditis.

The diagnosis of Q fever endocarditis cannot be made by bacterial cultures and necessitates serological identification of specific antibodies to Coxiella burnetii which stimulates mainly the production of anti-phase II antibodies during the acute disease, but primarily anti-phase I antibodies in endocarditis. Indirect microimmunofluorescence allows rapid detection of specific IgA, IgG and IgM. The results of serological analyses of 191 acute cases of Q fever were compared with those of 8 cases of Coxiella burnetii endocarditis. All sera were evaluated by complement fixation and microimmunofluorescence tests. The highest titre differences between primary Q fever and Q fever endocarditis were observed with anti-phase I IgA and IgG antibodies measured by microimmunofluorescence followed by anti-phase I antibodies measured by complement fixation tests. Antiphase I IgG and IgM titres were consistently higher than anti-phase II titres in endocarditis. The reverse is true in acute Q fever. In addition, anti-phase I IgA appeared to be diagnostic for Coxiella burnetii endocarditis. Accordingly we recommend the testing of these specific IgA, IgG, and IgM by microimmunofluorescence in cases of culture-negative endocarditis. These tests could also prove useful for following the development of Coxiella burnetii endocarditis in patients under treatment.

Antibodies, Bacterial↗

PubMed2006

Chronic Q fever in the United States.

Infections due to Coxiella burnetii, the causative agent of Q fever, are uncommon in the United States. Cases of chronic Q fever are extremely rare and most often manifest as culture-negative endocarditis in patients with underlying valvular heart disease. We describe a 31-year-old farmer from West Virginia with a history of congenital heart disease and recurrent fevers for 14 months who was diagnosed with Q fever endocarditis based on an extremely high antibody titer against Coxiella burnetii phase I antigen. Despite treatment with doxycycline, he continued to have markedly elevated Coxiella burnetii phase I antibody titers for 10 years after the initial diagnosis. To our knowledge, this case represents the longest follow-up period for a patient with chronic Q fever in the United States. We review all cases of chronic Q fever reported in the United States and discuss important issues pertaining to epidemiology, diagnosis, and management of this disease.

Adult↗

PubMed1997

[Frequency and etiology of calf losses and calf diseases in cow-calf farms. III. seroprevalence of selected diseases and prevalence of endoparasites and weaning age].

In a cross sectional study in 38 cow-calf farms blood and fecal samples were taken from 207 calves at an age of 8-10 months and their darms, in order to determine the seroprevalence of Leptospira hardjo, Coxiella burnetii, Toxoplasma gondii and the presence of the BVD-Antigen as well as the prevalence of endoparasites. The study was conducted in fall 1994 at the end of the grazing period. Eggs or larvaes of gastrointestinal helminths were detected in 74% of calves that were dewormed before the grazing period and in 88% of untreated calves. The difference between the two groups was statistically significant. In 83% of the weaned calves oocysts of Eimeria spp. were diagnosed. No significant difference in weight gain was observed between animals without endoparasites and animals infected with either helminths and/or Eimeria. In cows the prevalence was 61.5% for helminths and 45.7% for Eimeria spp. In calves the seroprevalence was 4% for Leptospira hardjo, 0.5% for Coxiella burnetii and 14.0% for Toxoplasma gondii. The seroprevalence in cows were 18% for Leptospira hardjo, 7.6% for Coxiella burnetii and 14.3% for Toxoplasma gondii. The prevalence of the BVD-Virus antigen was 0.5% for calves and cows.

Aging↗

PubMed1993

Three-dimensional reconstruction of Coxiella burnetii-infected L929 cells by high-voltage electron microscopy.

Previous examination of thin sections of L929 cells heavily infected with the Q fever Priscilla isolate by conventional transmission electron microscopy indicated that the rickettsiae resided within multiple vacuoles. The present study using high-voltage electron microscopy and three-dimensional reconstruction revealed that, in heavily infected cells, the rickettsiae, in fact, reside in one multilobed vacuole. As a result of asymmetric cell division, the multilobed vacuole containing the rickettsiae apparently segregates into one daughter cell, while the companion daughter cell emerges parasite free. This likely explains the appearance of naive uninfected cells in long-term-infected (i.e., ca. 2 years) cell populations that had not been supplemented with uninfected L929 host cells.

Animals↗

PubMed1997

Combined determination of Coxiella burnetii-specific immunoglobulin M (IgM) and IgA improves specificity in the diagnosis of acute Q fever.

Immunoglobulin M (IgM) and IgA responses in patients with acute Q fever were compared by enzyme-linked immunosorbent assay. An increase in both IgM and IgA was observed in paired sera from all 19 patients with acute Q fever, and both IgM and IgA levels showed good correlation with complement fixation test titers. Paired sera from 23 patients with infections other than Q fever were also tested. IgM levels were elevated in three of these patients, while IgA levels were elevated in three different patients (87% specificity for either IgM or IgA). As no patients in the disease control group showed elevated levels of both IgM and IgA, definition of a positive result as elevated levels of both IgM and IgA improved specificity to 100% without a decrease in sensitivity. This study indicates that detection of specific IgA is a useful adjunct to that of IgM in the diagnosis of acute Q fever.

Antibodies, Bacterial↗

PubMed1997

[Community acquired pneumonia. Reliability of the criteria for deciding ambulatory treatment].

To determine whether criteria for not admitting community-acquired pneumonia (CAP) patients diagnosed in the emergency room are appropriate, and to characterize the symptoms, etiology and course of CAP. This one-year prospective, protocol study of immunocompetent CAP patients diagnosed in the emergency room of our hospital enrolled patients not considered to require hospital admission according to the recommendations of the Spanish Society of Respiratory Disease (SEPAR). Medical histories, chest X-rays and blood analysis were obtained for all patients. Blood cultures were analyzed for antibodies against Legionella pneumophila, Mycoplasma pneumoniae, Coxiella burnetii, Chlamydia pneumoniae, Chlamydia psittaci and influenza virus types A and B. The patients received erythromycin for 14 days and were regularly checked by the pulmonologist in the outpatient clinic until signs and symptoms had disappeared. One hundred six patients were enrolled. Mean age was 36 +/- 13 years. Only 3 patients had to be admitted to hospital, after which outcome was good. The main symptoms were fever (106, 100%) and cough (83, 78%). In 46 (43.4%) chest sounds were normal. Microbiologic diagnoses were achieved for 28 (26.4%) and Coxiella burnetii was the agent most often found (19, 17.9%). Outcome was good in all cases, with faster disappearance of symptoms than of radiological signs. The SEPAR criteria for admitting patients with CAP are appropriate. The clinical symptoms of such patients are non specific, a noteworthy finding being that many patients had normal chest sounds. Coxiella burnetii was the most common causative agent. Both clinical and radiological outcomes were excellent.

Adolescent↗

PubMedDate not supplied

Serologic survey in animals of 'Q' fever in Nuevo Leon.

The serological prevalence of Q fever in Mexico is unknown. A serological survey for Coxiella burnetii was undertaken on a randomly selected population of dairy cattle, beef cattle, goats and sheep flocks. Serological examination of animal sera for antibodies against Coxiella burnetii was carried out by the ELISA technique. The 28% of the dairy cattle and 10% of beef cattle examinated were antibody positive. Sera from goats and sheep also had antibodies against this rickettsia, 35% and 40% respectively.

Animals↗

PubMed2005

Q fever epidemic among employees in a factory in the suburb of Zadar, Croatia.

AIM: To examine the role of wind in the spread of Q fever (Coxiella burnetii) from the source of infection (sheep on the pastures) to the factory where there was an outbreak of Q fever among the employees. METHODS: We performed clinical (fever, coughing, myalgias, arthralgias), laboratory (complete blood test, aminotransferases, antibodies to Coxiella burnetii), radiographic (chest X-ray), and epidemiological (questionnaire) analysis on 47 of 110 employees of the plant in a suburb of Zadar. Sera of 182 sheep were tested for antibody to C. burnetii by complement fixation reaction. RESULTS: During the first half of March 2004, 14 of 110 employees of a factory in a suburb of Zadar were diagnosed with Q fever on the basis of clinical and laboratory findings. In three sections of the plant, directly exposed to the north wind, a diagnosis of Q fever was confirmed in 14 of 110 employees by clinical, laboratory, and X-ray analysis, whereas there were no sick employees in the other four sections. North of the plant there were pastures where many flocks of sheep grazed. Antibodies to C. burnetii were found in 20 out of 182 sheep sera. Employees who were exposed to the north wind, had a significantly higher possibility of acquiring Q fever than did those working in sections protected from the wind. CONCLUSION: North wind (bura) containing the aerosolized C. burnetii likely influenced the Q fever outbreak in persons far from the source of the infection.

Adult↗

PubMed2006

Louse-borne bacterial pathogens in lice (Phthiraptera) of rodents and cattle from Egypt.

We collected 1,023 lice, representing 5 species, from rats and domestic cattle throughout 13 governorates in Egypt and tested these lice for Anaplasma marginale, Bartonella spp., Brucella spp., Borrelia recurrentis, Coxiella burnetii, Francisella tularensis, and Rickettsia spp. by PCR amplification and sequencing. Five different louse-borne bacterial agents were detected in lice from rodents or cattle, including "Bartonella rattimassiliensis", "B. phoceensis", and Bartonella sp. near Bartonella tribocorum, Coxiella burnetii, and Rickettsia typhi. More lice from governorates bordering the Mediterranean and Red Seas contained pathogens. Our data indicate that lice of urban and domestic animals harbor pathogenic or potentially pathogenic bacterial agents throughout Egypt.

Animals↗

PubMed2004

Toxoplasma and coxiella infection and psychiatric morbidity: a retrospective cohort analysis.

BACKGROUND: It has been suggested that infection with Toxoplasma gondii is associated with slow reaction and poor concentration, whilst infection with Coxiella burnetii may lead to persistent symptoms of fatigue. METHODS: 425 farmers completed the Revised Clinical Interview Schedule (CIS-R) by computer between March and July 1999 to assess psychiatric morbidity. Samples of venous blood had been previously collected and seroprevalence of T. gondii and C. burnetii was assessed. RESULTS: 45% of the cohort were seropositive for T. gondii and 31% were positive for C. burnetii. Infection with either agent was not associated with symptoms reflecting clinically relevant levels of concentration difficulties, fatigue, depression, depressive ideas or overall psychiatric morbidity. CONCLUSIONS: We do not provide any evidence that infection with Toxoplasma gondii or Coxiella burnetii is associated with neuropsychiatric morbidity, in particular with symptoms of poor concentration or fatigue. However, this is a relatively healthy cohort with few individuals reporting neuropsychiatric morbidity and therefore the statistical power to test the study hypotheses is limited.

Adult↗

PubMed2006

Isolation of Spiroplasma sp. from an Ixodes tick.

Spiroplasmas are helical mycoplasmas which are found in plants and arthropods, also in ticks. Some Spiroplasma species are incriminated as potential pathogens for vertebrates. During a study on Q fever in North Rhine-Westphalia, an intracellularly growing microorganism could be isolated from a pool of Ixodes ticks. The agent replicated within cytoplasmic vacuoles similar to those of Coxiella burnetii. PCR using coxiellae-, ehrlichiae- or chlamydiae-specific primers showed that agent Z/16 was distinct from these bacteria. In contrast to coxiellae or chlamydiae, the agent could not be stained according to the method of Giménez. Also electron microscopy provided evidence that the isolate Z/16 is different from coxiellae and chlamydiae. Determination of 16S ribosomal RNA gene sequences provided evidence that the isolate Z/16 can be classified as Spiroplasma sp. To our knowledge, this is the first report of an isolation of a Spiroplasma strain using a mammalian cell line. The pathogenic potential of the organism needs further investigation.

Animals↗

PubMed2004

Q fever and lymphadenopathy: report of four new cases and review.

Coxiella burnetii, the causative agent of Q fever, is responsible for various clinical syndromes, but lymphadenitis has been described during Q fever in only three recent case reports. Four new cases of acute Q fever associated with lymphadenopathy are reported here, and these cases are discussed along with the three previously reported cases. Coxiella burnetii was isolated for the first time from a lymph node. Q fever should be considered an etiologic agent of lymphadenitis.

Adult↗