Rheumatology Medical News about Coxiella burnetii Infection

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Systemic immune presentations of Coxiella burnetii infection (Q fever)
Seminars in Arthritis and Rheumatism, 04/17/09

Lefebvre M et al. – Study suggest that clinicians must be aware of the potential diagnosis of Q fever, and C. burnetii serology is a helpful diagnostic tool in the investigation of fever of unknown origin with atypical systemic symptoms suggesting vasculitis or inflammatory disease.

Methods

Study reports 7 cases of Q fever mimicking vasculitis, systemic inflammatory disease, or auto-immune disorder
These cases were diagnosed between 1995 and 2007 in France
They occurred in a nonendemic region and were selected on the basis of initial clinical presentation suggesting systemic immune disease
C. burnetii was detected using indirect IFC serology

Results

Q fever was acute in 4/7 pts and chronic in 3
None had endocarditis; initial presentations suggested:
- Crohn's disease
- Goodpasture's syndrome
- Polymyalgia rheumatica
- Adult-onset Still's disease
- Polyarteritis nodosa
- Giant-cell arteritis
- and essential type II cryoglobulinemia
2 pts had antiphospholipid antibodies, 1 transient IgG κ monoclonal gammopathy, and 1 polyclonal T CD8+ large granular lymphocyte expansion