Molecular detection of Coxiella burnetii from the formalin-fixed tissues of Q fever patients with acute hepatitis.

Serologic diagnosis is one of the most widely used diagnostic methods for Q fever, but the window period in antibody response of 2 to 3 weeks after symptom onset results in significant diagnostic delay. We investigated the diagnostic utility of Q fever PCR from formalin-fixed liver tissues in Q feve...

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Main Authors: Young-Rock Jang, Yong Shin, Choong Eun Jin, Bonhan Koo, Se Yoon Park, Min-Chul Kim, Taeeun Kim, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Jun Hee Woo, Sung-Han Kim, Eunsil Yu
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC5495296?pdf=render
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author Young-Rock Jang
Yong Shin
Choong Eun Jin
Bonhan Koo
Se Yoon Park
Min-Chul Kim
Taeeun Kim
Yong Pil Chong
Sang-Oh Lee
Sang-Ho Choi
Yang Soo Kim
Jun Hee Woo
Sung-Han Kim
Eunsil Yu
author_facet Young-Rock Jang
Yong Shin
Choong Eun Jin
Bonhan Koo
Se Yoon Park
Min-Chul Kim
Taeeun Kim
Yong Pil Chong
Sang-Oh Lee
Sang-Ho Choi
Yang Soo Kim
Jun Hee Woo
Sung-Han Kim
Eunsil Yu
author_sort Young-Rock Jang
collection DOAJ
description Serologic diagnosis is one of the most widely used diagnostic methods for Q fever, but the window period in antibody response of 2 to 3 weeks after symptom onset results in significant diagnostic delay. We investigated the diagnostic utility of Q fever PCR from formalin-fixed liver tissues in Q fever patients with acute hepatitis.We reviewed the clinical and laboratory data in patients with Q fever hepatitis who underwent liver biopsy during a 17-year period, and whose biopsied tissues were available. We also selected patients who revealed granuloma in liver biopsy and with no Q fever diagnosis within the last 3 years as control. Acute Q fever hepatitis was diagnosed if two or more of the following clinical, serologic, or histopathologic criteria were met: (1) an infectious hepatitis-like clinical feature such as fever (≥ 38°C) with elevated hepatic transaminase levels; (2) exhibition of a phase II immunoglobulin G (IgG) antibodies titer by IFA of ≥ 1:128 in single determination, or a four-fold or greater rise between two separate samples obtained two or more weeks apart; (3) histologic finding of biopsy tissue showing characteristic fibrin ring granuloma.A total of 11 patients with acute Q fever hepatitis were selected and analyzed. Of the 11 patients, 3 (27%) had exposure to zoonotic risk factors and 7 (63%) met the serologic criteria. Granulomas with either circumferential or radiating fibrin deposition were observed in 10 cases on liver biopsy and in 1 case on bone marrow biopsy. 8 (73%) revealed positive Coxiella burnetii PCR from their formalin-fixed liver tissues. In contrast, none of 10 patients with alternative diagnosis who had hepatic granuloma revealed positive C. burnetii PCR from their formalin-fixed liver tissues.Q fever PCR from formalin-fixed liver tissues appears to be a useful adjunct for diagnosing Q fever hepatitis.
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spelling doaj.art-42777c4a8b184a9a95e13dcd9e5e8cd12022-12-22T03:54:03ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01127e018023710.1371/journal.pone.0180237Molecular detection of Coxiella burnetii from the formalin-fixed tissues of Q fever patients with acute hepatitis.Young-Rock JangYong ShinChoong Eun JinBonhan KooSe Yoon ParkMin-Chul KimTaeeun KimYong Pil ChongSang-Oh LeeSang-Ho ChoiYang Soo KimJun Hee WooSung-Han KimEunsil YuSerologic diagnosis is one of the most widely used diagnostic methods for Q fever, but the window period in antibody response of 2 to 3 weeks after symptom onset results in significant diagnostic delay. We investigated the diagnostic utility of Q fever PCR from formalin-fixed liver tissues in Q fever patients with acute hepatitis.We reviewed the clinical and laboratory data in patients with Q fever hepatitis who underwent liver biopsy during a 17-year period, and whose biopsied tissues were available. We also selected patients who revealed granuloma in liver biopsy and with no Q fever diagnosis within the last 3 years as control. Acute Q fever hepatitis was diagnosed if two or more of the following clinical, serologic, or histopathologic criteria were met: (1) an infectious hepatitis-like clinical feature such as fever (≥ 38°C) with elevated hepatic transaminase levels; (2) exhibition of a phase II immunoglobulin G (IgG) antibodies titer by IFA of ≥ 1:128 in single determination, or a four-fold or greater rise between two separate samples obtained two or more weeks apart; (3) histologic finding of biopsy tissue showing characteristic fibrin ring granuloma.A total of 11 patients with acute Q fever hepatitis were selected and analyzed. Of the 11 patients, 3 (27%) had exposure to zoonotic risk factors and 7 (63%) met the serologic criteria. Granulomas with either circumferential or radiating fibrin deposition were observed in 10 cases on liver biopsy and in 1 case on bone marrow biopsy. 8 (73%) revealed positive Coxiella burnetii PCR from their formalin-fixed liver tissues. In contrast, none of 10 patients with alternative diagnosis who had hepatic granuloma revealed positive C. burnetii PCR from their formalin-fixed liver tissues.Q fever PCR from formalin-fixed liver tissues appears to be a useful adjunct for diagnosing Q fever hepatitis.http://europepmc.org/articles/PMC5495296?pdf=render
spellingShingle Young-Rock Jang
Yong Shin
Choong Eun Jin
Bonhan Koo
Se Yoon Park
Min-Chul Kim
Taeeun Kim
Yong Pil Chong
Sang-Oh Lee
Sang-Ho Choi
Yang Soo Kim
Jun Hee Woo
Sung-Han Kim
Eunsil Yu
Molecular detection of Coxiella burnetii from the formalin-fixed tissues of Q fever patients with acute hepatitis.
PLoS ONE
title Molecular detection of Coxiella burnetii from the formalin-fixed tissues of Q fever patients with acute hepatitis.
title_full Molecular detection of Coxiella burnetii from the formalin-fixed tissues of Q fever patients with acute hepatitis.
title_fullStr Molecular detection of Coxiella burnetii from the formalin-fixed tissues of Q fever patients with acute hepatitis.
title_full_unstemmed Molecular detection of Coxiella burnetii from the formalin-fixed tissues of Q fever patients with acute hepatitis.
title_short Molecular detection of Coxiella burnetii from the formalin-fixed tissues of Q fever patients with acute hepatitis.
title_sort molecular detection of coxiella burnetii from the formalin fixed tissues of q fever patients with acute hepatitis
url http://europepmc.org/articles/PMC5495296?pdf=render
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