Volume 21, Number 7—July 2015
Policy Review
Chronic Q Fever Diagnosis—Consensus Guideline versus Expert Opinion
Table 4
Characteristics and outcome of patients diagnosed with chronic Q fever using the Dutch consensus guideline* but without (definite) chronic Q fever according to alternative criteria†
Dutch consensus guideline |
Alternative criteria |
|
---|---|---|
Possible Q fever endocarditis or vascular infection, no. (%), n =14 |
No diagnosis, no. (%), n = 173 |
|
Proven Q fever | 8 (57.1) | 46 (26.6) |
Endocarditis | 8 (57.1) | 18 (10.4); |
PCR positive for Coxiella burnetii in blood | 6 (42.9) | 18 (10.4) |
Evidence of endocardial involvement | 2 (14.3) | 0 |
Vascular infection | 0 | 24 (13.9)‡ |
PCR positive in blood | 0 | 7 (4.0) |
Vascular focus on imaging | 0 | 17 (9.8) |
Other or no focus§ | 0 | 7 (4.1) |
Deceased | 2 (14.3) | 8 (4.6) |
Death probably due to Q fever |
2 (14.3) |
4 (2.3)¶ |
Probable Q fever | 6 (42.9) | 58 (33.5) |
Endocarditis | 4 (28.6) | 22 (12.7) |
Vascular infection | 2 (14.3) | 16 (9.3) |
Other or no focus | 0 | 20 (11.6) |
Deceased | 2 (14.3) | 4 (2.3) |
Death probably due to Q fever | 1 (7.1) | 0 |
Possible Q fever | 0 | 69 (39.9) |
*Source (14).
†Source (16).
‡In 3 patients with proven chronic Q fever, imaging studies showed that the focus of infection was in both the heart valves and the vascular structures.
§All were PCR positive.
¶For 2 patients, PCR of vascular and heart valve tissue obtained at autopsy was positive for C. burnetii.
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1A complete list of the group members is provided at the end of this article.