Chronic Q Fever: Ninety-two Cases From France, Including 27 Cases Without Endocarditis
Chronic Q Fever: Ninety-two Cases From France, Including 27 Cases Without Endocarditis
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慢性Q热：法国92例，其中27例无心内膜炎
DOI：
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
D. Raoult
中科院分区：
文献类型：
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作者：
P. Brouqui;H. Dupont;M. Drancourt;Y. Berland;J. Etienne;C. Leport;F. Goldstein;Philippe Massip;M. Micoud;André Bertrand;D. Raoult
目的：慢性Q热是一种罕见的疾病；1989年以前，文献报道的病例只有234例。法国立克次体病国家参考中心从1982年到1990年收集的92例慢性Q热病例是迄今为止报道的最大的系列病例。患者：纳入研究的患者在1982年7月31日至1990年8月1日期间在法国立克次体病国家参考中心诊断为慢性Q热，标准如下：通过间接免疫荧光试验，存在针对伯氏柯谢氏菌I期抗原的抗体，IgG滴度大于等于800，IgA滴度大于等于50。流行病学、临床、实验室和治疗数据收集自法国39家不同的合作医院。主要结局测量：对每位血清学选择的患者，采用计算机化问卷记录188项不同的人口统计学、流行病学、临床、实验室和治疗数据，并进行分析。结果：慢性Q热在城市居民中的发病率高于农村居民，暴露于家养反刍动物和原料奶是其重要特征。免疫功能低下（20.2%）和潜在心脏病（88.4%）或血管疾病是慢性Q热潜在病例中最重要的危险因素。心内膜炎患者死亡率高（23.5%）。84例患者的临床谱包括心内膜炎57例，血管假体感染3例，动脉瘤感染3例，骨关节炎3例，肺定位4例，无症状9例，肝炎3例，皮肤型2例。结论：对于不明原因发热、血培养阴性、有潜在血管或心脏病史的患者，应考虑Q热。（Arch Intern Med. 1993;153:642-648）
Objective: Chronic Q fever is seldom recognized; before 1989, only 234 cases had been reported in the literature. The 92 cases of chronic Q fever collected at the French National Reference Center for Rickettsioses from 1982 through 1990 represent the largest series ever reported. Patients: The patients included in the study were diagnosed between July 31, 1982, and August 1, 1990, at the French National Reference Center for Rickettsioses as having chronic Q fever by the following criteria: presence of antibody againstCoxiella burnetiiphase I antigen at a titer greater than or equal to 800 for IgG and 50 for IgA by the indirect immunofluorescence test. Epidemiologic, clinical, laboratory, and treatment data were collected from 39 different collaborative hospitals throughout France. Main Outcome Measure: For each serologically selected patient, a computerized questionnaire was utilized to record 188 different items of demographic, epidemiologic, clinical, laboratory, and therapeutic data, which were analyzed. Results: Chronic Q fever occurs more frequently in city dwellers than in rural inhabitants, and exposure to domestic ruminants and raw milk is an important feature. Immunocompromising conditions (20.2%) and underlying heart disease (88.4%) or vascular disease are the most important risk factors to consider in potential cases of chronic Q fever. The mortality in these patients with endocarditis was high (23.5%). The clinical spectrum of 84 patients included 57 cases of endocarditis, three cases of vascular prosthesis infection, three cases of aneurysmal infection, three cases of osteoarthritis, four cases with lung localizations, nine asymptomatic cases, three cases of hepatitis, and two cases with cutaneous forms of the disease. Conclusions: In patients with unexplained fever, negative blood cultures, and a history of underlying vascular or cardiac disease, Q fever should be considered. (Arch Intern Med. 1993;153:642-648)
Q 热中的细胞免疫：Q 热心内膜炎中的特异性淋巴细胞无反应。
DOI：
10.1093/infdis/152.6.1283
发表时间：
1985
期刊：
The Journal of infectious diseases
影响因子：
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作者：
Koster,FT;Williams,JC;Goodwin,JS
通讯作者：
Goodwin,JS