Clinical characteristics of Q fever and etiology of community-acquired pneumonia in a tropical region of southern Taiwan: a prospective observational study.
The clinical characteristics of Q fever are poorly identified in the tropics. Fever with pneumonia or hepatitis are the dominant presentations of acute Q fever, which exhibits geographic variability. In southern Taiwan, which is located in a tropical region, the role of Q fever in community-acquired...
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Public Library of Science (PLoS)
2014-01-01
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author | Chung-Hsu Lai Lin-Li Chang Jiun-Nong Lin Wei-Fang Chen Yu-Feng Wei Chien-Tung Chiu Jiun-Ting Wu Chi-Kuei Hsu Jung-Yueh Chen Ho-Sheng Lee Hsi-Hsun Lin Yen-Hsu Chen |
author_facet | Chung-Hsu Lai Lin-Li Chang Jiun-Nong Lin Wei-Fang Chen Yu-Feng Wei Chien-Tung Chiu Jiun-Ting Wu Chi-Kuei Hsu Jung-Yueh Chen Ho-Sheng Lee Hsi-Hsun Lin Yen-Hsu Chen |
author_sort | Chung-Hsu Lai |
collection | DOAJ |
description | The clinical characteristics of Q fever are poorly identified in the tropics. Fever with pneumonia or hepatitis are the dominant presentations of acute Q fever, which exhibits geographic variability. In southern Taiwan, which is located in a tropical region, the role of Q fever in community-acquired pneumonia (CAP) has never been investigated.During the study period, May 2012 to April 2013, 166 cases of adult CAP and 15 cases of acute Q fever were prospectively investigated. Cultures of clinical specimens, urine antigen tests for Streptococcus pneumoniae and Legionella pneumophila, and paired serologic assessments for Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Q fever (Coxiella burnetii) were used for identifying pathogens associated with CAP. From April 2004 to April 2013 (the pre-study period), 122 cases of acute Q fever were also included retrospectively for analysis. The geographic distribution of Q fever and CAP cases was similar. Q fever cases were identified in warmer seasons and younger ages than CAP. Based on multivariate analysis, male gender, chills, thrombocytopenia, and elevated liver enzymes were independent characteristics associated with Q fever. In patients with Q fever, 95% and 13.5% of cases presented with hepatitis and pneumonia, respectively. Twelve (7.2%) cases of CAP were seropositive for C. burnetii antibodies, but none of them had acute Q fever. Among CAP cases, 22.9% had a CURB-65 score ≧2, and 45.8% had identifiable pathogens. Haemophilus parainfluenzae (14.5%), S. pneumoniae (6.6%), Pseudomonas aeruginosa (4.8%), and Klebsiella pneumoniae (3.0%) were the most common pathogens identified by cultures or urine antigen tests. Moreover, M. pneumoniae, C. pneumoniae, and co-infection with 2 pathogens accounted for 9.0%, 7.8%, and 1.8%, respectively.In southern Taiwan, Q fever is an endemic disease with hepatitis as the major presentation and is not a common etiology of CAP. |
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id | doaj.art-17e551bfd13b40c1bc1a767765e5041c |
institution | Directory Open Access Journal |
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language | English |
last_indexed | 2024-12-19T08:59:32Z |
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spelling | doaj.art-17e551bfd13b40c1bc1a767765e5041c2022-12-21T20:28:30ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0197e10280810.1371/journal.pone.0102808Clinical characteristics of Q fever and etiology of community-acquired pneumonia in a tropical region of southern Taiwan: a prospective observational study.Chung-Hsu LaiLin-Li ChangJiun-Nong LinWei-Fang ChenYu-Feng WeiChien-Tung ChiuJiun-Ting WuChi-Kuei HsuJung-Yueh ChenHo-Sheng LeeHsi-Hsun LinYen-Hsu ChenThe clinical characteristics of Q fever are poorly identified in the tropics. Fever with pneumonia or hepatitis are the dominant presentations of acute Q fever, which exhibits geographic variability. In southern Taiwan, which is located in a tropical region, the role of Q fever in community-acquired pneumonia (CAP) has never been investigated.During the study period, May 2012 to April 2013, 166 cases of adult CAP and 15 cases of acute Q fever were prospectively investigated. Cultures of clinical specimens, urine antigen tests for Streptococcus pneumoniae and Legionella pneumophila, and paired serologic assessments for Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Q fever (Coxiella burnetii) were used for identifying pathogens associated with CAP. From April 2004 to April 2013 (the pre-study period), 122 cases of acute Q fever were also included retrospectively for analysis. The geographic distribution of Q fever and CAP cases was similar. Q fever cases were identified in warmer seasons and younger ages than CAP. Based on multivariate analysis, male gender, chills, thrombocytopenia, and elevated liver enzymes were independent characteristics associated with Q fever. In patients with Q fever, 95% and 13.5% of cases presented with hepatitis and pneumonia, respectively. Twelve (7.2%) cases of CAP were seropositive for C. burnetii antibodies, but none of them had acute Q fever. Among CAP cases, 22.9% had a CURB-65 score ≧2, and 45.8% had identifiable pathogens. Haemophilus parainfluenzae (14.5%), S. pneumoniae (6.6%), Pseudomonas aeruginosa (4.8%), and Klebsiella pneumoniae (3.0%) were the most common pathogens identified by cultures or urine antigen tests. Moreover, M. pneumoniae, C. pneumoniae, and co-infection with 2 pathogens accounted for 9.0%, 7.8%, and 1.8%, respectively.In southern Taiwan, Q fever is an endemic disease with hepatitis as the major presentation and is not a common etiology of CAP.http://europepmc.org/articles/PMC4102556?pdf=render |
spellingShingle | Chung-Hsu Lai Lin-Li Chang Jiun-Nong Lin Wei-Fang Chen Yu-Feng Wei Chien-Tung Chiu Jiun-Ting Wu Chi-Kuei Hsu Jung-Yueh Chen Ho-Sheng Lee Hsi-Hsun Lin Yen-Hsu Chen Clinical characteristics of Q fever and etiology of community-acquired pneumonia in a tropical region of southern Taiwan: a prospective observational study. PLoS ONE |
title | Clinical characteristics of Q fever and etiology of community-acquired pneumonia in a tropical region of southern Taiwan: a prospective observational study. |
title_full | Clinical characteristics of Q fever and etiology of community-acquired pneumonia in a tropical region of southern Taiwan: a prospective observational study. |
title_fullStr | Clinical characteristics of Q fever and etiology of community-acquired pneumonia in a tropical region of southern Taiwan: a prospective observational study. |
title_full_unstemmed | Clinical characteristics of Q fever and etiology of community-acquired pneumonia in a tropical region of southern Taiwan: a prospective observational study. |
title_short | Clinical characteristics of Q fever and etiology of community-acquired pneumonia in a tropical region of southern Taiwan: a prospective observational study. |
title_sort | clinical characteristics of q fever and etiology of community acquired pneumonia in a tropical region of southern taiwan a prospective observational study |
url | http://europepmc.org/articles/PMC4102556?pdf=render |
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