Diana J Kelm1, Darin B White2, Hind J Fadel3, Jay H Ryu1, Fabien Maldonado4, Misbah Baqir1. 1. Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic Rochester, Minnesota, USA. 2. Department of Radiology, Mayo Clinic Rochester, Minnesota, USA. 3. Department of Internal Medicine, Division of Infectious Diseases, Mayo Clinic Rochester, Minnesota, USA. 4. Department of Internal Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University, Nashville, Tennessee, USA.
Abstract
BACKGROUND: Lung involvement in both acute and chronic Q fever is not well described with only a few reported cases of pseudotumor or pulmonary fibrosis in chronic Q fever. The aim of this study was to better understand the pulmonary manifestations of Q fever. METHODS: We conducted a retrospective cohort study of patients with diagnosis of Q fever at Mayo Clinic Rochester. A total of 69 patients were initially identified between 2001 and 2014. Thirty-eight patients were included in this study as 3 were pediatric patients, 20 did not meet serologic criteria for Q fever, and 8 did not have imaging available at time of initial diagnosis. Descriptive analysis was conducted using JMP software. RESULTS: The median age was 57 years [interquartile range (IQR) 43, 62], 84% from the Midwest, and 13% worked in an occupation involving animals. The most common presentation was fevers (61%). Respiratory symptoms, such as cough, were noted in only 4 patients (11%). Twelve patients (29%) had abnormal imaging studies attributed to Q fever. Three patients (25%) with acute Q fever had findings of consolidation, lymphadenopathy, pleural effusions, and nonspecific pulmonary nodules. Radiographic findings of chronic Q fever were seen in 9 patients (75%) and included consolidation, ground-glass opacities, pleural effusions, lymphadenopathy, pulmonary edema, and lung pseudotumor. CONCLUSIONS: Our results demonstrate that pulmonary manifestations are uncommon in Q fever but include cough and consolidation for acute Q fever and radiographic findings of pulmonary edema with pleural effusions, consolidation, and pseudotumor in those with chronic Q fever.
BACKGROUND: Lung involvement in both acute and chronic Q fever is not well described with only a few reported cases of pseudotumor or pulmonary fibrosis in chronic Q fever. The aim of this study was to better understand the pulmonary manifestations of Q fever. METHODS: We conducted a retrospective cohort study of patients with diagnosis of Q fever at Mayo Clinic Rochester. A total of 69 patients were initially identified between 2001 and 2014. Thirty-eight patients were included in this study as 3 were pediatric patients, 20 did not meet serologic criteria for Q fever, and 8 did not have imaging available at time of initial diagnosis. Descriptive analysis was conducted using JMP software. RESULTS: The median age was 57 years [interquartile range (IQR) 43, 62], 84% from the Midwest, and 13% worked in an occupation involving animals. The most common presentation was fevers (61%). Respiratory symptoms, such as cough, were noted in only 4 patients (11%). Twelve patients (29%) had abnormal imaging studies attributed to Q fever. Three patients (25%) with acute Q fever had findings of consolidation, lymphadenopathy, pleural effusions, and nonspecific pulmonary nodules. Radiographic findings of chronic Q fever were seen in 9 patients (75%) and included consolidation, ground-glass opacities, pleural effusions, lymphadenopathy, pulmonary edema, and lung pseudotumor. CONCLUSIONS: Our results demonstrate that pulmonary manifestations are uncommon in Q fever but include cough and consolidation for acute Q fever and radiographic findings of pulmonary edema with pleural effusions, consolidation, and pseudotumor in those with chronic Q fever.
Authors: A E Voloudaki; D P Kofteridis; I N Tritou; N C Gourtsoyiannis; Y J Tselentis; A I Gikas Journal: Radiology Date: 2000-06 Impact factor: 11.105
Authors: D Raoult; H Tissot-Dupont; C Foucault; J Gouvernet; P E Fournier; E Bernit; A Stein; M Nesri; J R Harle; P J Weiller Journal: Medicine (Baltimore) Date: 2000-03 Impact factor: 1.889
Authors: P Brouqui; H T Dupont; M Drancourt; Y Berland; J Etienne; C Leport; F Goldstein; P Massip; M Micoud; A Bertrand Journal: Arch Intern Med Date: 1993-03-08
Authors: Y Tselentis; A Gikas; D Kofteridis; E Kyriakakis; N Lydataki; D Bouros; N Tsaparas Journal: Clin Infect Dis Date: 1995-05 Impact factor: 9.079