García-Clemente Marta, Seco-García Ana José, Gutiérrez-Rodríguez Margarita, Romero-Alvarez Pedro, Fernández-Bustamante Julio, Rodríguez-Pérez Mercedes
Sección de Neumología, Hospital Alvarez-Buylla, Mieres, España.
Enferm Infecc Microbiol Clin. 2007 Mar;25(3):184-6. doi: 10.1157/13099370.
The aim of this study was to describe an outbreak of Q fever pneumonia in the North of Spain.
We report 60 cases of Coxiella burnetii pneumonia in a rural area with 16,000 inhabitants during January and February 2003. The diagnosis was serologically confirmed by indirect immunofluorescence.
Mean age of the patients was 46 years and the male/female ratio was 2.5. Overall, 52% of the patients lived in urbanized areas and contact with animals was declared in only 7% of patients. Sixty percent of patients were hospitalized. The most frequent clinical presentation was an acute febrile process (100%) and headache (80%); respiratory symptoms were infrequent. The most common liver function alteration was elevated transaminase levels (35%). Radiologic evidence of a single lobar or segmental alveolar opacity was found in 87% of patients, and most commonly affected the lower lobes. Chest radiographs returned to normal in 70% of patients within the two first months. Empirical treatment consisted of beta-lactams and macrolides in 38%, macrolides alone in 8%, and quinolones in 23%; 27% were treated with beta-lactams alone. No deaths occurred.
Coxiella burnetii infection is very prevalent in the north of Spain and should be suspected and investigated when outbreaks of a pneumonic illness occur.
本研究旨在描述西班牙北部Q热肺炎的一次暴发。
我们报告了2003年1月和2月在一个有16,000名居民的农村地区发生的60例伯氏考克斯体肺炎病例。诊断通过间接免疫荧光血清学确诊。
患者的平均年龄为46岁，男女比例为2.5。总体而言，52%的患者居住在城市化地区，仅7%的患者声明与动物有接触。60%的患者住院治疗。最常见的临床表现是急性发热过程（100%）和头痛（80%）；呼吸道症状不常见。最常见的肝功能改变是转氨酶水平升高（35%）。87%的患者有单个肺叶或肺段肺泡实变的影像学证据，最常累及下叶。70%的患者在最初两个月内胸部X线片恢复正常。经验性治疗中，38%的患者使用β-内酰胺类和大环内酯类药物，8%的患者仅使用大环内酯类药物，23%的患者使用喹诺酮类药物；27%的患者仅使用β-内酰胺类药物治疗。无死亡病例发生。
伯氏考克斯体感染在西班牙北部非常普遍，当发生肺炎性疾病暴发时应怀疑并进行调查。
