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- Title
High Incidence of Asymptomatic Phase I IgG Seroconversion After an Acute Q Fever Episode: Implications for Chronic Q Fever Diagnosis.
- Authors
Rodríguez-Fernández, Miguel; Gómez, Reinaldo Espíndola; Trigo-Rodríguez, Marta; Castro, Carmen; Pérez-Crespo, Pedro Martínez; Herrero, Rocío; León, Eva M; Bernal, Samuel; Corzo, Juan E; Merchante, Nicolás
- Abstract
Background The aim of this study was to describe the natural history of acute Q fever, including its clinical and serological evolution and progression to chronic Q fever. Methods Observational cohort study (January 2011–September 2020) performed at Valme University Hospital (Seville, Spain). Inclusion criteria: (1) patients aged ≥18 years; (2) acute Q fever diagnosis, defined as suggestive symptoms in the presence of phase II immunoglobulin G (IgG) titer >1:256; (3) at least 6 months' follow-up after the acute Q fever episode. The incidence of seroconversion to a chronic Q fever serological pattern, defined as phase I IgG titers ≥1:1024 6 months after acute Q fever diagnosis, was assessed. Results During the study period, 117 patients were included. Thirty-four (29%) patients showed phase I IgG titers ≥1:1024 6 months after acute Q fever diagnosis. All patients with classic serological criteria for chronic Q fever diagnosis remained asymptomatic despite no specific treatment, with a median (quartile 1–quartile 3 [Q1–Q3]) follow-up of 26.5 (14–44) months in this subgroup. No cases of Q fever endocarditis nor other persistent focalized infection forms were observed during the study period. Conclusions A significant proportion of acute Q fever patients develop classic serological criteria for chronic Q fever diagnosis in the absence of additional data of chronic Q fever. Consequently, phase I IgG cutoff titers >1:800 should not be used as a criterion to consider such a diagnosis. The incidence of persistent focalized infection forms after acute Q fever is extremely low and does not justify the use of prophylaxis strategies.
- Subjects
SPAIN; CHRONIC disease diagnosis; Q fever; ACADEMIC medical centers; SCIENTIFIC observation; SEROCONVERSION; DISEASE incidence; LONGITUDINAL method; SYMPTOMS
- Publication
Clinical Infectious Diseases, 2022, Vol 74, Issue 12, p2122
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciab843