Department of Internal Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Clin Microbiol Infect. 2015 May;21(5):459-63. doi: 10.1016/j.cmi.2015.01.005. Epub 2015 Jan 16.
Q fever, caused by Coxiella burnetii, can present as an outbreak of acute disease ranging from asymptomatic disease, pneumonia, hepatitis or fever of unknown origin, which can progress to a chronic disease, most frequently endocarditis. The occurrence of Q fever within families is rarely described, and in most cases presents with uniform acute disease manifestations. Here we present a familial cluster of Q fever presenting as highly variable synchronous manifestations in four of five family members, including prolonged fever of unknown origin, asymptomatic carrier state, hepatitis, and chronic endocarditis developing in the absence of previous symptoms. This case series highlights the possibility of Q fever developing in cohabitated individuals with highly variable symptoms masking the common disease etiology. Screening of all exposed individuals, even those not clinically suspected to be infected, may enable to better identify, treat and prevent progression to chronic disease.
Q 热是由贝纳柯克斯体引起的，可表现为急性疾病暴发，从无症状疾病、肺炎、肝炎或原因不明发热，可进展为慢性疾病，最常见的是心内膜炎。家庭内 Q 热的发生很少被描述，且在大多数情况下具有一致的急性疾病表现。在此，我们报告了一个家族性 Q 热簇，其中五名家庭成员中有四名表现出高度可变的同步表现，包括原因不明的长期发热、无症状携带状态、肝炎和慢性心内膜炎，而无先前症状。本病例系列强调了在同居者中发生 Q 热的可能性，这些人具有高度可变的症状，掩盖了常见的病因。对所有暴露者进行筛查，即使是那些临床上怀疑未感染的人，也可能有助于更好地识别、治疗和预防慢性疾病的进展。
