Schneider T, Jahn H U, Steinhoff D, Guschoreck H M, Liesenfeld O, Mäter-Böhm H, Wesirow A L, Lode H, Ludwig W D, Dissmann T
Medizinische Klinik und Poliklinik, Klinikum Steglitz der Freien Universität, Berlin.
Dtsch Med Wochenschr. 1993 May 14;118(19):689-95. doi: 10.1055/s-2008-1059379.
An epidemic of Q fever in Berlin affected at least 80 patients (45 females, 35 males; age range 1-75 years). Sheep were identified as the focus of infection: they had been brought to a veterinary clinic because of nonspecific symptoms. The peak incidence of the infection was in April and May, 1992. Most of the patients were staff or students at the veterinary clinic. This is the most northern and, at the same time largest, Q fever epidemic recorded in Germany over the last 28 years. The complement fixation reaction (CFR) was not helpful diagnostically in the acute stage of the disease as it remained negative in the first 14 days (CFR < or = 1:5). Most of the patients had sudden fever to over 40 degrees C, severe headache and dry cough. Pulmonary infiltrates were seen in the chest radiograph of 8 of the 10 patients presented in this contribution. Auscultation was largely negative. Two patients had signs of hepatic involvement (GPT as high as 71 U/l). The drug of choice was doxycycline at a dosage of 200 mg twice daily for 14 days.
柏林发生的一场Q热疫情至少影响了80名患者（45名女性，35名男性；年龄范围为1至75岁）。已确定羊是感染源：它们因出现非特异性症状而被送至一家兽医诊所。感染的高峰期出现在1992年4月和5月。大多数患者是该兽医诊所的工作人员或学生。这是德国过去28年中记录到的最北部同时也是规模最大的Q热疫情。在疾病急性期，补体结合反应（CFR）对诊断并无帮助，因为在最初14天内其结果一直为阴性（CFR≤1:5）。大多数患者突然发热至40摄氏度以上，伴有严重头痛和干咳。在本报告中呈现的10名患者中，有8人的胸部X光片显示有肺部浸润。听诊大多无异常。两名患者有肝脏受累迹象（谷丙转氨酶高达71 U/l）。首选药物是强力霉素，剂量为每日2次，每次200毫克，连用14天。
