ABSTRACT
Introducción y objetivos. La fiebre Q (infección por Coxiella burnetii es una zoonosis infradiagnosticada en nuestro medio. Se describen las características de la fiebre Q en una zona donde antes no se habían descrito y se valoran las variaciones ocurridas en la última década. Material y métodos. Estudio de 124 casos de fiebre Q diagnosticados en la Unidad de Patología Infecciosa del Hospital Universitario Infanta Cristina de Badajoz (1992-2005). Se analizan los datos epidemiológicos, clínicos, serológicos, terapéuticos y los factores relacionados con el ingreso. Resultados. La edad media fue de 41 ± 16 años, predominaron los varones (relación 4:1), el 61% vivía en el medio rural y el 47% tenían contacto con animales de granja. Las formas clínicas de presentación fueron la fiebre sin focalidad (53%), la hepatitis (43%), la neumonía (11%) y la endocarditis (6%). Los factores relacionados con la necesidad de ingreso fueron: el diagnóstico a partir de 1999 (odds ratio [OR]: 12,2; intervalo de confianza del 95% [IC 95%]: 3,2-47,6), la neumonía (OR: 4,1; IC 95%: 1,1-15,9) y la hepatitis (OR: 2,7; IC 95%: 1,2-6,3). Durante la segunda mitad del período de estudio hubo más diagnósticos, la duración de los síntomas previos al diagnóstico fue menor (p = 0,042) y hubo más hospitalizaciones (55% frente a 9%; p < 0,0001). Conclusiones. En Extremadura, la fiebre Q es una infección emergente que predomina en varones en contacto con ganado. La forma de presentación más frecuente es el síndrome febril sin localidad. Es poco frecuente la neumonía. En los últimos años han aumentado el diagnóstico y los ingresos hospitalarios (AU)
Introduction and objectives. Q fever (Coxiella burnetii infection) is an underdiagnosed zoonosis in our area, Extremadura, a rural region in the Southwest of Spain. The characteristics of Q fever and the changes in this infection seen over the last decade in our hospital are described. Material and methods. A total of 124 cases of Q fever diagnosed in the Infectious Diseases Unit of a tertiary hospital Hospital Universitario Infanta Cristina de Badajoz) during the years 1992-2005 were analyzed. The epidemiological, clinical, serological and therapeutic data of the patients, and the factors related with hospital admittance are described. Results. Mean age was 41 ± 16 years, most patients were males (4:1 ratio), 61% lived in rural areas and 47% mentioned some kind of contact with farm animals. The clinical presentation included non-focalized fever (53%), hepatitis (43%), pneumonia (11%), and endocarditis (6%). The factors related with the need for hospital admission were diagnosis after 1999 (OR: 12.2; 95% CI: 3.2-47.6), pneumonia (OR: 4.1; 95% CI: 1.1-15.9), and hepatitis (OR: 2.7; 95% CI: 1.2-6.3). During the second half of the study period there were more cases of Q fever, the interval of time to diagnosis was shorter (P = 0.042), and there was a significant increase in hospitalizations (55% versus 9%; P < 0.0001). Conclusions. In Extremadura, Q fever is an emerging infection that predominates in males who are in contact with animals for work purposes. Non-focalized fever is the most frequent form of clinical presentation; pneumonia is rare. Hospitalization for Q fever infection has increased over the last years (AU)
Subject(s)
Male , Female , Adolescent , Adult , Humans , Q Fever/epidemiology , Coxiella burnetii/pathogenicity , Q Fever/diagnosis , Zoonoses/epidemiology , Socioeconomic Factors , Seasons , Signs and Symptoms , Retrospective Studies , Hepatitis/etiology , Pneumonia/etiologyABSTRACT
INTRODUCTION AND OBJECTIVES: Q fever (Coxiella burnetii infection) is an underdiagnosed zoonosis in our area, Extremadura, a rural region in the Southwest of Spain. The characteristics of Q fever and the changes in this infection seen over the last decade in our hospital are described. MATERIAL AND METHODS: A total of 124 cases of Q fever diagnosed in the Infectious Diseases Unit of a tertiary hospital Hospital Universitario Infanta Cristina de Badajoz) during the years 1992-2005 were analyzed. The epidemiological, clinical, serological and therapeutic data of the patients, and the factors related with hospital admittance are described. RESULTS: Mean age was 41 +/- 16 years, most patients were males (4:1 ratio), 61% lived in rural areas and 47% mentioned some kind of contact with farm animals. The clinical presentation included non-focalized fever (53%), hepatitis (43%), pneumonia (11%), and endocarditis (6%). The factors related with the need for hospital admission were diagnosis after 1999 (OR: 12.2; 95% CI: 3.2-47.6), pneumonia (OR: 4.1; 95% CI: 1.1-15.9), and hepatitis (OR: 2.7; 95% CI: 1.2-6.3). During the second half of the study period there were more cases of Q fever, the interval of time to diagnosis was shorter (P = 0.042), and there was a significant increase in hospitalizations (55% versus 9%; P < 0.0001). CONCLUSIONS: In Extremadura, Q fever is an emerging infection that predominates in males who are in contact with animals for work purposes. Non-focalized fever is the most frequent form of clinical presentation; pneumonia is rare. Hospitalization for Q fever infection has increased over the last years.
