Coxiella burnetii in Egyptian children with hepatitis

ABSTRACT

To estimate the incidence of Coxiella burnetii infection among Egyptian children with hepatitis Ain Shams University Children's Hospital and Imbaba Fever Hospital Included ninety children aged between 5-14 years [median 10 years]. Male to female ratio was 2 1. They were divided into two groups, group [I] comprised sixty children with hepatitis and group [2] included thirty healthy children [controls]. Both groups were age and sex matched. Both groups were subjected to history taking, thorough clinical examination and investigations which included complete hemogram and ESR levels, liver function tests and serologic tests for the detection of HAV IgM antibodies [ELISA], HBs Ag HBs-Ab [ELISA], HCV antibodies [INNO test] and Coxiella burnetii IgM antibodies [indirect fluorescence technique]. The present study showed that the incidence of Coxiella burnetii infection [Q fever] among patients with hepatitis was 11.7% and those of hepatitis A, B, C and other undiagnosed hepatitides were [48.3%], [20%], [6.7%] and [13.3%] respectively. High fever and CNS manifestations but not hepatomegaly and/or deep jaundice were the cardinal findings in all cases of Q fever hepatitis. Meanwhile, two out of seven [28.57%] cases had pneumonia but none had any cardiac abnormalities. Significant leukocytosis and high ESR levels were observed in patients with Q fever hepatitis. The liver enzymes were markedly elevated in all patients with hepatitis including Q fever with insignificant difference between different groups. Q fever hepatitis is not uncommon in children. The diagnosis should be considered in any child presenting with hepatitis specially when there is high fever, CNS symptoms, leukocytosis and elevated ESR levels