| Q fever as a cause of fever of unknown origin |
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Sang Taek Heo, Mi Yeoun Park, Young Sill Choi, Won Sup Oh, Kwan Soo Ko, Kyong Ran Peck, Jae-Hoon Song |
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경희대학교 의과대학 순환기내과학교실 |
| 증례 : Q열로 진단된 불명열 3예 |
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허상택, . 박미연 . 최영실 . 오원섭 . 고관수, . 백경란 . 송재훈, Won Sup Oh, Kwan Soo Ko, Kyong Ran Peck, Jae-Hoon Song |
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| Abstract |
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Q fever is an orthozoonotic infection caused by Coxiella burnetii, which was recently reclassified from the order Rickettsials to the order Legionellales. Although Q fever is usually mild and self-limiting, it may be manifested as a serious disease, such as pneumonia, endocarditis, or meningoencephalitis. We describe three separate cases of acute Q fever, which were diagnosed by an indirect micro‐immunofluorescence assay (MIFA) test and DNA amplification (PCR). Three adult patients were admitted between December 2004 and August 2006 because of a fever of greater than three weeks duration. Only one patient had contact history with a dog. Of the three patients, two patients had myalgia, headache, skin rash, lymphadenopathy, and hepatosplenomegaly. Although all sets of blood cultures were negative, anti-phase II antibody titers by using an indirect MIFA (IgG 1:512–1,024 and IgM 1:320) were markedly increased in sera from all of three patients. Concomitant PCR assays also demonstrated the presence of OMP com1 for C. burnetii in blood from all of the three patients. Two patients had complete resolution of symptoms and signs with a two‐week course of doxycycline, while one patient had spontaneous defervescence. Although the incidence of Q fever is not well known yet in Korea, it should be considered in the differential diagnosis of patients with fever of unknown origin. (Korean J Med 74:100-105, 2008) |
| Key Words:
Q fever; Coxiella burnetii; Fever of unknown origin |
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