[CHRONIC Q FEVER IN PATIENTS AT THE HILLEL YAFFE MEDICAL CENTER - THREE YEARS OF FOLLOW UP].

INTRODUCTION

Q fever is an acute zoonotic infection, which in some cases is complicated by a chronic disease. Diagnosis is based on serology, and in patients with a chronic disease, the source of infection must be investigated.

AIMS: To describe patients with chronic Q fever, who were treated at the Hillel Yaffe Medical Center: risk factors, course of the disease, and serological findings.

METHODS

This was an observational study; patients with chronic Q fever who were treated in the Infectious Diseases Clinic during the period 5/2015 - 1/2018 were included. The diagnosis was based on clinical findings and results of phase 1 IgG ≥ 800. Clinical, laboratory and imaging data from diagnosis to the end of treatment were collected.

RESULTS

Sixteen patients were included in the study; all these patients were treated with antibiotics, and three also underwent operations. Risk factors for a chronic infection were a significant valvular disease in 11 patients (69%) and vascular diseases in five (31%). Trans-esophageal echocardiogram (TEE) was performed in 13 patients (81%), and a 18F-FDG/PET-CT was performed in eight patients (50%). The source of infection was found in seven patients, four with endocarditis and three with vascular infection.

CONCLUSIONS

Endocarditis was more common than vascular infection. In 56% of the patients, the source of the infection was not found.

DISCUSSION: We presented patients with chronic Q fever who were treated in a unique clinic in Israel. Diagnosing the source of the infection is challenging; the increasing use of 18F-FDG/PET-CT allowed accurate diagnosis in some patients in which TEE results were negative.