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- W197455211 abstract "From 2007-2010, during the recent Q fever epidemic in the Netherlands, over 4000 cases of acute Q fever were registered, which is an underestimation of the total amount of Coxiella burnetii infections due to a high amount of asymptomatic primary infections. In the literature it is stated that 1-5% of patients develop chronic Q fever after acute Q fever. We demonstrated that the risk for development of chronic Q fever after a known acute Q fever episode is approximately 2.5% for all chronic Q fever cases, and 1.5% if limited to proven and probable chronic Q fever cases. We have also demonstrated that the majority of patients with chronic Q fever did not recall an acute Q fever episode. From the Dutch National Chronic Q Fever Database we identified 284 chronic Q fever patients of whom 151 (53.7%) had proven, 64 (22.5%) probable and 69 (24.3%) possible chronic Q fever. The majority of proven and probable chronic Q fever patients had a vascular focus of infection (56.7%), while endocarditis (34.9%) was less prevalent. We described that most patients who died of chronic Q fever-related complications, had a vascular focus of infection (79%). Previously proposed risk factors for the development of chronic Q fever consist of pre-existing cardiac valvulopathy, vascular grafts and aneurysms, immunosuppression and pregnancy. Identified risk factors for chronic Q fever in this thesis were previous cardiac valvular surgery, vascular prosthesis, aneurysms, renal insufficiency, and increasing age. An association between immunosuppression and pregnancy, and chronic Q fever could not be confirmed in this study. A novel finding was the association between mild renal insufficiency and chronic Q fever. Increasing age also predisposed for the development of chronic Q fever. The diagnostic criteria of chronic Q fever have recently led to debate in the international literature. A positive C. burnetii PCR, in the absence of signs of acute Q fever, proves chronic Q fever, but this method has low sensitivity in blood. Until now, diagnosis of chronic Q fever relied mainly on serological examination. In this thesis, we have demonstrated that high phase I IgG titres have a high positive predictive value (PPV) to differentiate proven chronic Q fever from possible chronic Q fever, especially if titres exceed 1:4096. Nevertheless, sensitivity of high phase I IgG titres is low: 60% in case of phase I IgG titres >1:4096. In contrast, phase I IgG titres between 1:1024 and 1:4096 have high sensitivity (98-81%), but a low PPV (62-77%). These results emphasizes that serology is not a diagnostic tool on its own, but should be interpreted in relation with the clinical background. The diagnostic guideline of the Dutch Q fever Consensus Group combines PCR, serology, clinical data and radiological data. In this guideline, suspected chronic Q fever cases are divided in three groups in decreasing likelihood of chronic Q fever: proven, probable and possible. We have demonstrated that the guideline of the Dutch Q fever Consensus Group has better sensitivity and also takes more rare manifestations of chronic Q fever into account" @default.
- W197455211 created "2016-06-24" @default.
- W197455211 creator A5046808165 @default.
- W197455211 date "2013-03-15" @default.
- W197455211 modified "2023-09-23" @default.
- W197455211 title "Chronic Q fever in The Netherlands" @default.
- W197455211 cites W111817313 @default.
- W197455211 cites W113968237 @default.
- W197455211 cites W1270473501 @default.
- W197455211 cites W131077381 @default.
- W197455211 cites W1511325471 @default.
- W197455211 cites W1595242379 @default.
- W197455211 cites W1657036249 @default.
- W197455211 cites W1701714503 @default.
- W197455211 cites W1871099561 @default.
- W197455211 cites W1872051922 @default.
- W197455211 cites W1947560712 @default.
- W197455211 cites W1957093558 @default.
- W197455211 cites W1963886255 @default.
- W197455211 cites W1969577943 @default.
- W197455211 cites W1971013173 @default.
- W197455211 cites W1978448533 @default.
- W197455211 cites W1981174792 @default.
- W197455211 cites W1981683008 @default.
- W197455211 cites W1981904722 @default.
- W197455211 cites W1992218427 @default.
- W197455211 cites W1995799136 @default.
- W197455211 cites W1996052697 @default.
- W197455211 cites W1996662362 @default.
- W197455211 cites W2002705506 @default.
- W197455211 cites W2004101198 @default.
- W197455211 cites W2007695299 @default.
- W197455211 cites W2007903251 @default.
- W197455211 cites W2010046091 @default.
- W197455211 cites W2016956418 @default.
- W197455211 cites W2017909609 @default.
- W197455211 cites W2029235053 @default.
- W197455211 cites W2034135634 @default.
- W197455211 cites W2037881440 @default.
- W197455211 cites W2040717742 @default.
- W197455211 cites W2041840016 @default.
- W197455211 cites W2044731156 @default.
- W197455211 cites W2046218291 @default.
- W197455211 cites W2048087799 @default.
- W197455211 cites W2048132371 @default.
- W197455211 cites W2048927554 @default.
- W197455211 cites W2050462438 @default.
- W197455211 cites W2050524462 @default.
- W197455211 cites W2053210634 @default.
- W197455211 cites W2059092789 @default.
- W197455211 cites W2064153594 @default.
- W197455211 cites W2064219824 @default.
- W197455211 cites W2065585920 @default.
- W197455211 cites W2065836891 @default.
- W197455211 cites W2070265803 @default.
- W197455211 cites W2071876736 @default.
- W197455211 cites W2080287073 @default.
- W197455211 cites W2082867083 @default.
- W197455211 cites W2085772932 @default.
- W197455211 cites W2089084549 @default.
- W197455211 cites W2091634426 @default.
- W197455211 cites W2094059628 @default.
- W197455211 cites W2095152560 @default.
- W197455211 cites W2097018658 @default.
- W197455211 cites W2098741784 @default.
- W197455211 cites W2098872329 @default.
- W197455211 cites W2100239481 @default.
- W197455211 cites W2101574740 @default.
- W197455211 cites W2101899844 @default.
- W197455211 cites W2102361557 @default.
- W197455211 cites W2103451304 @default.
- W197455211 cites W2104595146 @default.
- W197455211 cites W2104649224 @default.
- W197455211 cites W2104721604 @default.
- W197455211 cites W2108346639 @default.
- W197455211 cites W2108661672 @default.
- W197455211 cites W2111917959 @default.
- W197455211 cites W2112831127 @default.
- W197455211 cites W2115343830 @default.
- W197455211 cites W2119122903 @default.
- W197455211 cites W2119826205 @default.
- W197455211 cites W2122826745 @default.
- W197455211 cites W2123620378 @default.
- W197455211 cites W2127897181 @default.
- W197455211 cites W2128993059 @default.
- W197455211 cites W2129335820 @default.
- W197455211 cites W2130362331 @default.
- W197455211 cites W2132546705 @default.
- W197455211 cites W2134075690 @default.
- W197455211 cites W2137998548 @default.
- W197455211 cites W2140193130 @default.
- W197455211 cites W2143101996 @default.
- W197455211 cites W2144655764 @default.
- W197455211 cites W2145099195 @default.
- W197455211 cites W2145707810 @default.
- W197455211 cites W2146002693 @default.
- W197455211 cites W2146304151 @default.
- W197455211 cites W2148276016 @default.
- W197455211 cites W2150016403 @default.
- W197455211 cites W2151688912 @default.