Q fever pneumonia: a review of 164 community-acquired cases in the Basque country.

One hundred and sixty four cases of Q fever pneumonia are reviewed. Coxiella burnetti is responsible for 18.8% of pneumonias acquired in the community in our region with an extremely high seasonal variation. 91% of the cases occur between January and June. 88.5% of the patients are less than 40 yrs of age and 77% are male. The most common clinical symptoms are high fever, cough, cephalalgia and myalgias. 46.5% of the patients have no respiratory symptoms although 34% of the cases report pleural pain. The radiological signs are nonspecific. With regard to laboratory data, it is often observed that the white blood cell count (WBC) is normal and the liver enzymes are abnormal (45%). Treatment with doxycycline reduces the fever more quickly than erythromycin.