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Emerg Infect Dis. 2015 Aug;21(8):1348-56. doi: 10.3201/eid2108.140196.

Differentiation of Acute Q Fever from Other Infections in Patients Presenting to Hospitals, the Netherlands


Differentiating acute Q fever from infections caused by other pathogens is essential. We conducted a retrospective case-control study to evaluate differences in clinical signs, symptoms, and outcomes for 82 patients with acute Q fever and 52 control patients who had pneumonia, fever and lower respiratory tract symptoms, or fever and hepatitis, but had negative serologic results for Q fever. Patients with acute Q fever were younger and had higher C-reactive protein levels but lower leukocyte counts. However, a large overlap was found. In patients with an indication for prophylaxis, chronic Q fever did not develop after patients received prophylaxis but did develop in 50% of patients who did not receive prophylaxis. Differentiating acute Q fever from other respiratory infections, fever, or hepatitis is not possible without serologic testing or PCR. If risk factors for chronic Q fever are present, prophylactic treatment is advised.


Coxiella burnetii; Q fever; acute Q fever; bacteria; case–control study; chronic Q fever; clinical practice; hospital; prophylactic treatment; prophylaxis; the Netherlands

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