Volume 18, Number 4—April 2012
Research
Identification of Risk Factors for Chronic Q Fever, the Netherlands
Linda M. Kampschreur
, Sandra Dekker, Julia C.J.P. Hagenaars, Peter J. Lestrade, Nicole H.M. Renders, Monique G.L. de Jager-Leclercq, Mirjam H.A. Hermans, Cornelis A.R. Groot, Rolf H.H. Groenwold, Andy I.M. Hoepelman, Peter C. Wever, and Jan Jelrik Oosterheert
, Sandra Dekker, Julia C.J.P. Hagenaars, Peter J. Lestrade, Nicole H.M. Renders, Monique G.L. de Jager-Leclercq, Mirjam H.A. Hermans, Cornelis A.R. Groot, Rolf H.H. Groenwold, Andy I.M. Hoepelman, Peter C. Wever, and Jan Jelrik OosterheertTable 1
Classification of chronic Q fever according to Dutch Q Fever Consensus Group guidelines*
| Classification | Definition |
|---|---|
| Proven | Any of the following: |
| Positive PCR for Coxiella burnetii in serum, plasma, or tissue in the absence of acute Q fever | |
| IFA phase I titer ≥1,024 with definite endocarditis according to the revised Duke criteria (21) | |
| Indication of vascular infection on PET/CT, CT, MRI, or ultrasound testing | |
| Probable | IFA phase I IgG titer >1,024 and any of the following clinical manifestations: |
| Valvulopathy not meeting the criteria of endocardial involvement of the major modified Duke criteria (22) | |
| Aneurysm, vascular prosthesis or prosthetic valve without signs of infection on PET/CT, CT, MRI, or ultrasound testing | |
| Signs of possible chronic Q fever infection of noncardiac or vascular origin on PET/CT, CT, or ultrasound testing | |
| Pregnancy | |
| Clinical symptoms of chronic infection (i.e., fever, night sweats, weight loss, hepatosplenomegaly) | |
| Histopathologic proven granulomatous inflammation | |
| Immune disorder | |
| Possible | IFA phase I IgG titer >1,024 without clinical manifestations as described above |
*Described in (20). IFA, immunofluorescence assay; PET, positron emission tomography; CT, computed tomography; MRI, magnetic resonance imaging.
