Chronic Q fever-related complications and mortality: data from a nationwide cohort.

Autor:	van Roeden SE; University Medical Centre Utrecht, Utrecht, the Netherlands. Electronic address: s.vanroeden@gmail.com., Wever PC; Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands., Kampschreur LM; Medical Centre Leeuwarden, Leeuwarden, the Netherlands., Gruteke P; Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands., van der Hoek W; National Institute for Public Health and the Environment, Bilthoven, the Netherlands., Hoepelman AIM; University Medical Centre Utrecht, Utrecht, the Netherlands., Bleeker-Rovers CP; Radboud university medical center, Nijmegen, the Netherlands., Oosterheert JJ; University Medical Centre Utrecht, Utrecht, the Netherlands.
Jazyk:	angličtina
Zdroj:	Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases [Clin Microbiol Infect] 2019 Nov; Vol. 25 (11), pp. 1390-1398. Date of Electronic Publication: 2018 Dec 10.
DOI:	10.1016/j.cmi.2018.11.023
Abstrakt:	Objectives: Chronic infection with Coxiella burnetii (chronic Q fever) can cause life-threatening conditions such as endocarditis, infected vascular prostheses, and infected arterial aneurysms. We aimed to assess prognosis of chronic Q fever patients in terms of complications and mortality. Methods: A large cohort of chronic Q fever patients was assessed to describe complications, overall mortality and chronic Q fever-related mortality. Chronic Q fever-related mortality was expressed as a case fatality rate (number of chronic Q fever-related deaths/number of chronic Q fever patients). Results: Complications occurred in 166 of 439 (38%) chronic Q fever patients: in 61% of proven (153/249), 15% of probable (11/74), and 2% of possible chronic Q fever patients (2/116). Most frequently observed complications were acute aneurysms (14%), heart failure (13%), and non-cardiac abscesses (10%). Overall mortality was 38% (94/249) for proven chronic Q fever patients (median follow-up 3.6 years) and 22% (16/74) for probable chronic Q fever patients (median follow-up 4.7 years). The case fatality rate was 25% for proven (63/249) chronic Q fever patients and 4% for probable (3/74) chronic Q fever patients. Overall survival was significantly lower in patients with complications, compared to those without complications (p <0.001). Conclusions: In chronic Q fever patients, complications occur frequently and contribute to the mortality rate. Patients with proven chronic Q fever have the highest risk of complications and chronic Q fever-related mortality. Prognosis for patients with possible chronic Q fever is favourable in terms of complications and mortality. (Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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