Harris R J, Storm P A, Lloyd A, Arens M, Marmion B P
School of Pharmacy and Medical Sciences, University of South Australia, Australia.
Epidemiol Infect. 2000 Jun;124(3):543-9. doi: 10.1017/s0950268899003763.
After a primary infection Coxiella burnetii may persist covertly in animals and recrudesce at parturition to be shed in the products of conception and the milk. Similar latent persistence and recrudescence occurs in man: namely, infection of placenta, heart valve or mural endocardium, bone or liver. The numbers of organisms, their viability and cellular form, and the underlying organ sites of latent infection for the coxiella are obscure. During investigations of 29 patients with a chronic sequel to acute Q fever, the post-Q fever fatigue syndrome (QFS) [1-3], sensitive conventional and TaqMan-based PCR revealed low levels of C. burnetii DNA in blood mononuclear cells (5/29; 17%), thin needle liver biopsies (2/14; 14%) and, notably, in bone marrow aspirates (13/20; 65%). Irrespective of the ultimate significance of coxiella persistence for QFS, the detection of C. burnetii genomic DNA in bone marrow several years after a primary infection unveils a new pathological dimension for Q fever.
原发性感染后,伯氏考克斯体可在动物体内隐匿持续存在,并在分娩时复发,随妊娠产物和乳汁排出。人类也会出现类似的潜伏持续和复发情况,即胎盘、心脏瓣膜或心内膜、骨骼或肝脏感染。伯氏考克斯体的菌体数量、活力和细胞形态以及潜伏感染的潜在器官部位尚不清楚。在对29例急性Q热慢性后遗症即Q热后疲劳综合征(QFS)患者的调查中,敏感的传统PCR和基于TaqMan的PCR显示,血液单核细胞(5/29;17%)、细针肝活检组织(2/14;14%),尤其是骨髓抽吸物(13/20;65%)中存在低水平的伯氏考克斯体DNA。无论伯氏考克斯体持续存在对QFS的最终意义如何,原发性感染数年之后在骨髓中检测到伯氏考克斯体基因组DNA揭示了Q热新的病理层面。