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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Main Authors: 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
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4102556?pdf=render
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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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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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