15 results on '"Q Fever drug therapy"'
Search Results
2. Doxycycline assay hair samples for testing long-term compliance treatment.
- Author
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Angelakis E, Armstrong N, Nappez C, Richez M, Chabriere E, and Raoult D
- Subjects
- Aged, Aged, 80 and over, Anti-Bacterial Agents blood, Anti-Bacterial Agents therapeutic use, Chromatography, Liquid, Doxycycline blood, Doxycycline therapeutic use, Female, Hair growth & development, Hair metabolism, Humans, Male, Middle Aged, Q Fever drug therapy, Time Factors, Whipple Disease drug therapy, Anti-Bacterial Agents analysis, Doxycycline analysis, Hair chemistry, Patient Compliance
- Abstract
Objectives: Many patients undergoing long-term doxycycline treatment do not regularly take their treatment because of photosensitivity. Our objective was to create an assay for determining doxycycline levels and to use hair samples for monitoring the compliance over a longer period of time., Methods: We tested sera and hair samples from patients treated with doxycycline by a suitable ultra-high performance liquid chromatography (UHPLC) based assay., Results: We estimated that the speed of hair growth is roughly 1.25 cm per month and we were able to determine doxycycline levels over a 6-month period. We tested 14 patients treated with doxycycline and we found similar levels of doxycycline in the serum and the hair samples representing the last 4 months. Linear regression analysis revealed that the level of doxycycline in the serum remained stable over time (p = 0.7) but the level of doxycycline in the hair decreased significantly over time (p = 0.03) indicating a degradation of this molecule in the hair. We detected two patients who did not have antibiotic in the hair, indicating a lack of compliance that was also confirmed by interview., Conclusion: Hair samples can be used to test long-term compliance in patients to explain failures or relapses., (Copyright © 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
3. The value of follow-up after acute Q fever infection.
- Author
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Healy B, Llewelyn M, Westmoreland D, Lloyd G, and Brown N
- Subjects
- Anti-Bacterial Agents administration & dosage, Antibodies, Bacterial blood, Chronic Disease, Complement Fixation Tests, Coxiella burnetii immunology, Coxiella burnetii isolation & purification, Doxycycline administration & dosage, Echocardiography, Transesophageal, Endocarditis, Bacterial drug therapy, Endocarditis, Bacterial microbiology, Female, Fluorescent Antibody Technique, Humans, Hydroxychloroquine administration & dosage, Middle Aged, Ofloxacin administration & dosage, Q Fever drug therapy, Q Fever microbiology, Delivery of Health Care standards, Endocarditis, Bacterial diagnosis, Endocarditis, Bacterial etiology, Q Fever complications, Q Fever diagnosis
- Abstract
This is a case report of a 53-year-old woman involved in an outbreak of Q fever, in whom Q fever endocarditis was diagnosed 18 months after acute Q fever infection. At the time of diagnosis, she was completely asymptomatic and without screening for chronic Q fever, this severe potentially life-threatening infection would probably not have been recognised until significant valvular destruction had taken place. Early diagnosis enabled prompt, potentially curative medical treatment to start without the need for valvular heart surgery. The authors advocate that serological monitoring should be carried out every 4 months for a period of 2 years after acute Q fever and patients with high phase 1 IgG titres (>800) be investigated further and/or followed more closely depending on the clinical scenario. The case report also discusses the use of complement fixation testing in the diagnosis of Q fever endocarditis. The authors recommend that in cases of culture negative endocarditis, a single negative complement fixation test is not sufficient to exclude the diagnosis of Q fever endocarditis. Micro-immunofluorescence or repeat complement fixation testing is recommended when Q fever endocarditis is suspected clinically.
- Published
- 2006
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4. Ongoing queries: Interpretation of serology in asymptomatic or atypical chronic Q fever.
- Author
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de Silva T, Chapman A, Kudesia G, and McKendrick M
- Subjects
- Anti-Bacterial Agents therapeutic use, Antithyroid Agents therapeutic use, Carbimazole therapeutic use, Chronic Disease, Coxiella burnetii isolation & purification, Doxycycline therapeutic use, Fluorescent Antibody Technique, Humans, Immunoglobulin G blood, Male, Middle Aged, Q Fever drug therapy, Q Fever immunology, Recurrence, Thyrotoxicosis complications, Thyrotoxicosis drug therapy, Antibodies, Bacterial blood, Coxiella burnetii immunology, Q Fever diagnosis
- Abstract
Chronic Q fever, predominantly associated with endocarditis, can develop insidiously. Although the diagnosis may be straightforward with a typical clinical presentation, incidental discovery of positive Coxiella burnetii serology poses a difficult clinical challenge. We describe the cases of two such patients and review the literature on the serological diagnosis of chronic Q fever.
- Published
- 2006
- Full Text
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5. Legionella and Q fever community acquired pneumonia in children.
- Author
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Scola BL and Maltezou H
- Subjects
- Child, Humans, Immunocompetence, Legionnaires' Disease diagnosis, Legionnaires' Disease drug therapy, Legionnaires' Disease epidemiology, Legionnaires' Disease etiology, Legionnaires' Disease immunology, Q Fever diagnosis, Q Fever drug therapy, Q Fever epidemiology, Q Fever etiology, Q Fever immunology
- Published
- 2004
- Full Text
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6. Q fever as a biological weapon.
- Author
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Kagawa FT, Wehner JH, and Mohindra V
- Subjects
- Anti-Infective Agents administration & dosage, Bioterrorism, Coxiella burnetii pathogenicity, Humans, Q Fever microbiology, Q Fever pathology, United States, Zoonoses, Q Fever diagnosis, Q Fever drug therapy
- Abstract
Q fever is a bacterial zoonosis caused by Coxiella burnetii, a unique intracellular coccobacillus, adapted to live within the phagolysosomes of macrophages and monocytes. It is highly infectious, with as little as one organism needed to cause clinical infection, making it an attractive organism for use in biowarfare. Despite its high infectivity, it has low virulence, and most patients undergo only asymptomatic seroconversion. Acute clinical manifestations are a nonspecific febrile illness, pneumonia, hepatitis, and neurologic abnormalities ranging from headache to meningoencephalitis. Chronic Q fever can result in endocarditis, hepatitis, or a chronic fatigue syndrome. Diagnosis usually is made by serology because culture of the highly contagious organism is potentially hazardous. Tetracyclines are the antibiotics of choice. When individualized therapy is possible, a 14- to 21-day course of doxycycline usually is used. In a mass casualty situation, a 5- to 7-day course of doxycycline is recommended, both for therapy and prophylaxis. For chronic infections such as endocarditis, 18 months of doxycycline supplemented with hydroxychloroquine is currently the best therapy.
- Published
- 2003
7. Q fever: epidemiology, clinical features and prognosis. A study from 1983 to 1999 in the South of Spain.
- Author
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Alarcón Ad, Villanueva JL, Viciana P, López-Cortés L, Torronteras R, Bernabeu M, Cordero E, and Pachón J
- Subjects
- Acute Disease, Adolescent, Adult, Aged, Chi-Square Distribution, Child, Female, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Q Fever diagnosis, Q Fever drug therapy, Risk Factors, Spain epidemiology, Statistics, Nonparametric, Urban Population, Q Fever epidemiology
- Abstract
Objectives: Clinical polymorphism is a main feature of Q fever and, depending upon the geographic location, differences in its clinical picture have been described. The objective of this study was to determine the epidemiology, clinical features and prognosis of acute Q fever in our area., Methods: From 1985 to 1999, consecutive cases of Q fever, presented as febrile syndrome and attended in a tertiary teaching hospital in Sevilla, Spain, were included and followed prospectively., Results: Two hundred and thirty-one cases of acute Q fever were included. A non-focalized febrile syndrome lasting from 7 to 28 days (fever of intermediate duration) was the most frequent presentation (n=208, 90%). One hundred and forty-eight patients had hepatitis. Overall, 53% of the cases were urban and contact with animals was referred in 39% of the patients. No relationship between clinical presentation and possible route of infection was observed. Prognosis was excellent (100% cured), although in 18 patients fever was prolonged more than 28 days and three patients developed life-threatening organ affection. Antimicrobial treatment was more effective if it was administered in the first two weeks (median defervescence of fever: 3 days versus 5.5 days, p<0.01)., Conclusions: Acute Q fever is a common cause of fever of intermediate duration, even in urban areas. Elevation of hepatic enzymes was the most frequent laboratory finding. Severe organ affection is uncommon and the overall prognosis of the disease is excellent. Early treatment seems to shorten the duration of the disease.
- Published
- 2003
- Full Text
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8. Doxycycline and chloroquine as treatment for chronic Q fever endocarditis.
- Author
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Calza L, Attard L, Manfredi R, and Chiodo F
- Subjects
- Aorta transplantation, Chronic Disease, Coxiella burnetii isolation & purification, Drug Therapy, Combination, Endocarditis, Bacterial microbiology, Heart Valve Prosthesis, Humans, Male, Middle Aged, Q Fever microbiology, Serologic Tests, Anti-Bacterial Agents therapeutic use, Chloroquine therapeutic use, Doxycycline therapeutic use, Endocarditis, Bacterial complications, Endocarditis, Bacterial drug therapy, Q Fever complications, Q Fever drug therapy
- Abstract
Endocarditis is a rare but severe complication of Q fever, an infectious disease caused by the intracellular pathogen Coxiella burnetii. Heart involvement is the most common clinical presentation of chronic Q fever, and it occurs almost invariably in patients with previous valvular disease or artificial valves, and in the immunocompromised host. The optimal treatment of Q fever endocarditis is still today debated, and recommended duration of treatment varies from one year to one's lifespan. A case of chronic Q fever endocarditis is described in a patient with biological prosthetic aortic valve and aortic homograft, successfully treated with doxycycline and chloroquine for 2 years.
- Published
- 2002
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9. Jarisch-Herxheimer reaction complicating the treatment of chronic Q fever endocarditis: elevated TNFalpha and IL-6 serum levels.
- Author
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Kaplanski G, Granel B, Vaz T, and Durand JM
- Subjects
- Anti-Bacterial Agents adverse effects, Anti-Bacterial Agents therapeutic use, Anti-Infective Agents adverse effects, Anti-Infective Agents therapeutic use, Chronic Disease, Doxycycline adverse effects, Doxycycline therapeutic use, Endocarditis, Bacterial immunology, Humans, Interleukin-6 blood, Male, Middle Aged, Ofloxacin adverse effects, Ofloxacin therapeutic use, Q Fever immunology, Q Fever microbiology, Time Factors, Tumor Necrosis Factor-alpha analysis, Coxiella burnetii isolation & purification, Drug Hypersensitivity, Endocarditis, Bacterial drug therapy, Endocarditis, Bacterial microbiology, Q Fever drug therapy
- Abstract
Jarisch-Herxheimer reaction (J-HR) is an acute febrile reaction which may complicate the initiation of an effective treatment against infections due to intracellular micro-organisms. We report a case of J-HR complicating treatment of chronic Q fever endocarditis with demonstration of elevated serum cytokine concentrations.
- Published
- 1998
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10. Q fever in pregnancy.
- Author
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Ludlam H, Wreghitt TG, Thornton S, Thomson BJ, Bishop NJ, Coomber S, and Cunniffe J
- Subjects
- Adult, Anti-Infective Agents therapeutic use, Cesarean Section, Ciprofloxacin therapeutic use, Female, Humans, Infection Control, Infectious Disease Transmission, Patient-to-Professional prevention & control, Obstetrics, Pregnancy, Pregnancy Complications, Infectious diagnosis, Pregnancy Complications, Infectious drug therapy, Q Fever diagnosis, Q Fever drug therapy, Q Fever transmission
- Abstract
We describe a case of acute symptomatic infection with Coxiella burnetii acquired between the 16th and 28th week of pregnancy. Oral ciprofloxacin therapy was started on diagnosis, at the 28th week of pregnancy, but symptoms were unabated after 3 weeks treatment, suggesting persisting infection of the products of conception. Caesarean section was therefore performed at 32 weeks gestation when a healthy infant was delivered, and subsequent investigations showed no evidence of transplacental spread of infection. Infection control measures were applied at the time of delivery to minimize the risk of infection to obstetricians and midwives from potentially infectious products of conception.
- Published
- 1997
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11. Q-fever pneumonia in the Negev region of Israel: a review of 20 patients hospitalised over a period of one year.
- Author
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Lieberman D, Lieberman D, Boldur I, Manor E, Hoffman S, Schlaeffer F, and Porath A
- Subjects
- Adult, Aged, Anti-Bacterial Agents therapeutic use, Community-Acquired Infections diagnosis, Community-Acquired Infections drug therapy, Female, Hospitalization, Humans, Israel epidemiology, Male, Middle Aged, Pneumonia, Bacterial diagnosis, Pneumonia, Bacterial drug therapy, Prospective Studies, Q Fever diagnosis, Q Fever drug therapy, Time Factors, Community-Acquired Infections epidemiology, Pneumonia, Bacterial epidemiology, Q Fever epidemiology
- Abstract
Background: Three-hundred and forty-six patients with community acquired pneumonia were included in a prospective study of patients hospitalised over a 12-month period in the Soroka Medical Center in Beer-Sheva, Israel. Q-fever pneumonia (QFP) was diagnosed in 20 patients (5.8%). A detailed epidemiological and clinical description of this disease, is presented., Methods: QFP was diagnosed by conventional criteria using a commercial immunofluorescent assay., Results: The age of patients was 41 +/- 14 years (mean +/- S.D., range 20-69). Twelve of the patients were males. No concomitant or chronic disease was present in 16 patients. Chest radiograms revealed alveolar or air space pneumonia in 10 patients, bronchopneumonia in nine and interstitial pneumonia in one patient. The mean febrile period was 10.5 +/- 5.3 days. There was serological evidence of co-infection with Mycoplasma pneumonia in six patients, and with Legionella pneumophila in one patient. Patients treated with beta-lactam antibiotics recovered as quickly as those treated with tetracyclines or erythromycin., Conclusions: The Negev region of Israel is an endemic area for Q-fever. The diagnosis of QFP can be made only on the basis of a specific serological test. Clinical, radiologic or laboratory findings are not diagnostically definitive. The importance of specific therapy is unclear.
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- 1995
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12. Chronic Q fever associated with granulomatous hepatitis.
- Author
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Weir WR, Bannister B, Chambers S, De Cock K, and Mistry H
- Subjects
- Adult, Chronic Disease, Humans, Male, Middle Aged, Q Fever drug therapy, Granuloma etiology, Hepatitis etiology, Q Fever complications
- Published
- 1984
- Full Text
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13. Prolonged Q fever associated with inappropriate secretion of anti-diuretic hormone.
- Author
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Biggs BA, Douglas JG, Grant IW, and Crompton GK
- Subjects
- Bone and Bones diagnostic imaging, Chronic Disease, Humans, Male, Middle Aged, Q Fever drug therapy, Radionuclide Imaging, Inappropriate ADH Syndrome etiology, Q Fever complications
- Abstract
A man with acute Q fever developed hyponatraemia associated with inappropriate secretion of anti-diuretic hormone. The pyrexial illness lasted for 9 weeks and failed to respond to tetracycline, erythromycin and intravenous lincomycin. Subsequently seroconversion indicated chronic Q fever.
- Published
- 1984
- Full Text
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14. Chronic Q fever.
- Subjects
- Chronic Disease, Coxiella isolation & purification, Humans, Q Fever diagnosis, Q Fever etiology, Tetracycline therapeutic use, Q Fever drug therapy
- Published
- 1984
- Full Text
- View/download PDF
15. Pneumonia and meningo-encephalitis due to Coxiella burnetii.
- Author
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Marrie TJ
- Subjects
- Adult, Antibodies, Bacterial analysis, Coxiella immunology, Erythromycin therapeutic use, Humans, Male, Meningoencephalitis etiology, Pneumonia etiology, Q Fever diagnosis, Q Fever drug therapy
- Abstract
We describe the case of a 35-year-old man who presented with pneumonia and encephalitis due to Coxiella burnetii. The neurological manifestations of Q fever are discussed and we suggest that C. burnetii be included in the differential diagnosis of patients with pneumonia and encephalitis.
- Published
- 1985
- Full Text
- View/download PDF
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