MedElevator
Войти в исследования Open forum infectious diseases · 2026
Retrospective Analysis of Chronic Q Fever Cases at a Tertiary Care Center From 2007 to 2023.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Dumais Mitchell G, Howick V James F, Garcia Sofia Molina, El Zein Said, Abu Saleh Omar
Аннотация
BACKGROUND: Chronic Q fever, caused by Coxiella burnetii, presents significant diagnostic and management challenges due to its variable presentation and high morbidity, especially among patients with underlying cardiac or vascular disease. In the United States, cases are rising, often without identifiable exposures, and diagnostic delays remain common.
METHODS: We conducted a retrospective cohort study of chronic Q fever cases at the Mayo Clinic from 2007 to 2023. Patients with clinical evidence and a phase I IgG titer ≥1:1024 and/or positive polymerase chain reaction for C burnetii were included. Data were abstracted from electronic health records, including demographics, exposures, clinical manifestations, diagnostics, treatments, and outcomes. Statistical analyses assessed factors influencing diagnostic delay and treatment response.
RESULTS: We identified 33 patients with chronic Q fever (median age 56; 88% male). Median time to diagnosis was 99 days, with 11.4 days between infectious diseases evaluation and diagnosis. Animal exposure was reported in 17 patients (52%), while 8 (24%) had no identifiable exposure. Patients primarily presented with prosthetic valve endocarditis (n = 14, 42%) or vascular graft infection (n = 9, 27%). The majority were treated with doxycycline and hydroxychloroquine (n = 25, 75%), and 14 patients (42%) required surgical intervention. Mortality attributable to chronic Q fever was 6% (n = 2).
CONCLUSIONS: Chronic Q fever remains under-recognized, with substantial diagnostic delays prior to treatment. Cardiovascular infection predominates, and surgical intervention is often required despite prolonged antimicrobial therapy. Early specialist evaluation and standardized diagnostic pathways may improve outcomes.
METHODS: We conducted a retrospective cohort study of chronic Q fever cases at the Mayo Clinic from 2007 to 2023. Patients with clinical evidence and a phase I IgG titer ≥1:1024 and/or positive polymerase chain reaction for C burnetii were included. Data were abstracted from electronic health records, including demographics, exposures, clinical manifestations, diagnostics, treatments, and outcomes. Statistical analyses assessed factors influencing diagnostic delay and treatment response.
RESULTS: We identified 33 patients with chronic Q fever (median age 56; 88% male). Median time to diagnosis was 99 days, with 11.4 days between infectious diseases evaluation and diagnosis. Animal exposure was reported in 17 patients (52%), while 8 (24%) had no identifiable exposure. Patients primarily presented with prosthetic valve endocarditis (n = 14, 42%) or vascular graft infection (n = 9, 27%). The majority were treated with doxycycline and hydroxychloroquine (n = 25, 75%), and 14 patients (42%) required surgical intervention. Mortality attributable to chronic Q fever was 6% (n = 2).
CONCLUSIONS: Chronic Q fever remains under-recognized, with substantial diagnostic delays prior to treatment. Cardiovascular infection predominates, and surgical intervention is often required despite prolonged antimicrobial therapy. Early specialist evaluation and standardized diagnostic pathways may improve outcomes.