Hassan Kowthar S, Al Lawati Batool, Al-Siyabi Turkiya
Infectious Diseases Unit, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman.
Rheumatology Unit, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman.
Oman Med J. 2024 Nov 30;39(6):e691. doi: 10.5001/omj.2024.110. eCollection 2024 Nov.
Q fever is a worldwide zoonosis, yet its prevalence may be underestimated due to the challenges in diagnosis. We present a series of cases where patients were treated for Q fever infection based primarily on their clinical features and available laboratory tests, highlighting the difficulties in establishing the diagnosis.
This 15-year case series was observed from January 2009 to November 2023 at Sultan Qaboos University Hospital, Oman. Relevant patient information was obtained from the electronic hospital records under the ethical approval MREC # 3139.
We treated 17 patients from a total of 1481 patients tested. The median age was 38 years, with a male-to-female ratio of 1.4:1. Fever was the most common symptom, and six patients experienced weight loss. Hepatobiliary, respiratory, neurological, and musculoskeletal symptoms occurred in 10, six, five, and four patients, respectively. Three patients developed rashes during their illness. Two patients had definite infective endocarditis, one had probable infective endocarditis, and two patients had pericardial effusion.
Q fever should be considered in the differential diagnosis of a wide range of clinical presentations. However, it can be clinically challenging, and serological test interpretation can be difficult in areas of endemicity and with limited diagnostic tests. A combination of compatible clinical illnesses and appropriate diagnostic tests is necessary for accurate diagnosis.
Q热是一种全球性人畜共患病,但由于诊断存在挑战,其患病率可能被低估。我们报告了一系列主要根据临床特征和现有实验室检查对Q热感染进行治疗的病例,突出了确诊的困难。
该15年病例系列于2009年1月至2023年11月在阿曼苏丹卡布斯大学医院观察。相关患者信息从电子医院记录中获取,研究获得了伦理批准MREC # 3139。
在总共1481名接受检测的患者中,我们治疗了17名患者。中位年龄为38岁,男女比例为1.4:1。发热是最常见的症状,6名患者出现体重减轻。分别有10名、6名、5名和4名患者出现肝胆、呼吸、神经和肌肉骨骼症状。3名患者在患病期间出现皮疹。2名患者患有确诊的感染性心内膜炎,1名可能患有感染性心内膜炎,2名患者有心包积液。
在多种临床表现的鉴别诊断中应考虑Q热。然而,它在临床上具有挑战性,在地方流行地区以及诊断检测有限的情况下,血清学检测结果的解读可能会很困难。准确诊断需要结合相符的临床病症和适当的诊断检测。