Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute Q fever was previously regarded as an uncommon infectious disease in Taiwan but has been increasingly recognized recently. Acute febrile illness, hepatitis, and pneumonia are the 3 most common manifestations of this condition, whereas jaundice is rarely reported among patients with acute Q fever. We report 2 cases of acute Q fever with jaundice and multi-organ involvement. The first patient presented with fever, severe headache, and acute abdomen necessitating laparotomy and was complicated with acute cholestatic hepatitis, acute non-oliguric renal failure and disseminated intravascular coagulation. The second patient had acute cholestatic hepatitis and thrombocytopenia, and the latter was likely related to the infection of bone marrow by Coxiella burnetii, as evidenced by the presence of C. burnetii DNA detected by nested polymerase chain reaction. The incidence and clinical significance of hyperbilirubinemia was also determined by review of medical records of 35 cases of acute Q fever cases diagnosed serologically at National Cheng Kung University Hospital from 1994 to 2001. All had biochemical hepatitis and 23% had hyperbilirubinemia (serum bilirubin > or =2 mg/dL). The febrile course before admission and the period between the initiation of effective medication to defervescence were longer in patients with hyperbilirubinemia than in patients without hyperbilirubinemia, although this difference was not significant. Our results suggest that the predominant presentation of acute Q fever in southern Taiwan is acute febrile illness with hepatitis and that jaundice is not uncommon. Due to the clinical polymorphism of acute Q fever, the threshold of surveys for C. burnetii infections should be low for febrile patients with elevated transaminases or hyperbilirubinemia of unknown cause.
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PMID:Acute hepatitis with or without jaundice: a predominant presentation of acute Q fever in southern Taiwan. 1518 92

Between the dates of May 4th-August 6th 2002, 46 cases were detected with abdominal pain nausea, vomiting, arthralgia/myalgia, headache, fever, diarrhea and rash, in the middle Blacksea and north inner Anatolia regions. Their laboratory findings yielded elevated levels of liver enzymes (AST, ALT, LDH), leucopenia and thrombocytopenia. As the infection was treated easily with tetracyclines, clinical diagnosis was considered to be rickettsiosis or ehrlichiosis. Serum and blood samples obtained from some of the patients were tested against Rickettsia, Ehrlichia, Leptospira and Coxiella, in the national and international laboratories. Samples from 19 patients were sent to National Reference Centre and WHO Collaborating Centre for Rickettsial Reference and Research Laboratory, France, and 7 of them were reported as acute Q fever while 8 of them were reported as passed Q fever (QF) cases. In May 2003, new cases with similar symptoms have been reported from the same regions, with different epidemiologic and serologic findings (tick exposure history was higher, response to tetracycline was lower, C. burnetii antibodies were negative), indicating a viral etiology. The samples of these patients have been sent to National Reference Centre and WHO Collaborating Centre for Arboviruses and Viral Heamorrhagic Fevers, France, and the initial reports were marked as Crimean Congo hemorrhagic fever virus (CCHFV). Then the serum samples of previous 26 patients which were stored in National Serum Bank have been retrospectively investigated for viral aetiology in the same center, and 17 of them have been found positive for CCHFV IgM antibodies. Four of these patients were diagnosed as acute QF in 2002, one was passed QF, 2 were negative for QF and 10 were patients not investigated for QF. As a result, the detection of the both infections together in the same area shows the essential need for further epidemiological investigations.
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PMID:[Epidemiological evaluation of a possible outbreak in and nearby Tokat province]. 1529

Coxiella burnetii the agent of Q fever produces a variety of clinical syndromes. Central nervous system (CNS) involvement is reported to be a rare feature of the disease usually presented as a severe headache and rarely as meningoencephalitis. We retrospectively studied the medical records of 49 patients with clinical signs of CNS involvement. Among 121 patients with acute Q fever infection 49 (40.5%) had some degree of neurological involvement, varying from a severe headache in the majority of the patients (40.5%) to confusion (4.1%) and meningitis (0.8%). The majority of these patients with CNS involvement (91%) had been admitted to the hospital as community acquired pneumonia. The clinical evidence of CNS involvement is not a rare feature of acute Q fever infection and Coxiella burnetii should be considered as a possible etiology of meningitis or meningoencephalitis in endemic areas.
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PMID:Neurological complications of acute Q fever infection. 1564 99

Between 4 May and 8 August 2002,46 cases of acute fever were reported near the Black Sea region in northern Turkey. The infection was treated rapidly and successfully with tetracyclines, so clinical diagnosis of rickettsial or ehrlichial infection was considered. Analysis of serum and blood samples taken from 19 patients identified the causative organism as Coxiella burnetii; 7 cases were reported as acute Q fever and 8 as seropositive for past infection. The most common clinical symptoms among the acute cases were vomiting (100.0%), nausea (85.7%), diarrhoea (57.1%), fever (42.9%), abdominal pain (42.9%) and headache (42.9%). Liver enzymes were elevated in all patients. It is considered that epidemiological investigation for Q fever will be essential in the affected region in future.
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PMID:Is Q fever an emerging infection in Turkey? 1660 58

Hemophagocytic syndrome is a rare complication of acute Q fever. We reported the case of 26-year-old man with fever, chills, severe headache, non-productive cough and progressive thrombocytopenia. Bone marrow aspirate revealed hemophagocytosis. We discussed the differences among the three previous reported cases and the possible mechanisms of hemophagocytic syndrome.
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PMID:Acute Q fever with hemophagocytic syndrome: case report and literature review. 1714 93

A 35 year old patient presented to the emergency room with high fever, headache and a maculopapular rash after returning from the Canary Islands. Elevated levels of LDH and transaminases and thrombopenia developed during the further hospital course. This presentation is common for an infection with Rickettsia typhi. Therapy with doxycycline is usually effective and should be instituted promptly. The patient's fever remitted 48 h after the first dose. Fever of intermediate duration has been described as a separate disease entity in the Mediterranean region and the Canary Islands. It is defined as fever of 7-28 days duration for which a complete basic workup fails to define an etiology. Most cases are due to one of six infectious diseases (Q fever, Mediterranean spotted fever, endemic typhus, leptospirosis, brucellosis and mononucleosis).
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PMID:[Fever of intermediate duration after return from the Canary Islands]. 1730 11

Q fever was diagnosed in a previously healthy man who had recently traveled to the East Coast of Australia. The patient experienced fever and headache accompanied by lymphopenia and elevated liver enzymes but not pneumonia. He had no known direct exposures to animals, exhibited IgM and IgG seroconversion to phase II antigen of Coxiella burnetii and IgM only to phase I antigen, and responded to doxycycline treatment. This case serves as a reminder to clinicians to consider Q fever in the differential diagnosis of acute febrile illness in travelers returning from endemic areas.
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PMID:Q fever in an American tourist returned from Australia. 1744 48

Acute Q fever is a worldwide zoonosis caused by Coxiella burnetii infection. In Taiwan, cases of acute Q fever increased during 3 y of observation, especially at Kaohsiung County and City in southern Taiwan. From 15 April 2004 to 15 April 2007, a total of 67 cases of acute Q fever were identified at E-Da hospital located at Kaohsiung County. 19 (28.4%) patients had a history of travel in rural areas and only 1 had been outside southern Taiwan. 21 (31.3%) patients had a history of animal contact. 20 (30.8%) of the 65 examined patients had underlying chronic hepatitis B or hepatitis C virus infection. Fever (98.5%), chills (79.1%), headache (79.1%), relative bradycardia (44.8%), elevated aminotransferases (100%), and thrombocytopenia (74.6%) were common manifestations. 12 (19.0%) cases had abnormal findings on chest X-ray. Fatty liver (50.0%) and hepatomegaly and/or splenomegaly (41.9%) were found by abdominal image examinations. 42 (76.4%) of 55 cases had defervescence within 3 d after treatment, whereas 4 (7.3%) had spontaneous remission. Acute Q fever is an endemic infectious disease with hepatitis rather than pneumonia as the major presentation in southern Taiwan and the emergence of Q fever is due to increased alertness for the disease by physicians.
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PMID:Acute Q fever: an emerging and endemic disease in southern Taiwan. 1785 9

The clinical information of acute Q fever in Taiwan was limited. A clinical study of 109 adults with serologically documented acute Q fever in the past decade (1994-2005) at 3 referral hospitals in southern Taiwan was reported. Their clinical manifestations, laboratory findings, and clinical outcomes were analyzed. Males predominated (98, 90%). There is a significant correlation between monthly average temperature and case numbers of acute Q fever (r = 0.74, P = 0.006). Fever (99%), chills (69%), and headache (45%) were the common symptoms, and relative bradycardia (44/60, 73 %) was often noted. Acute hepatitis, defined as either serum aspartate aminotransferase >or=60 IU/L or alanine aminotransferase >or=78 IU/L, was found in 88 (85%) cases, and more than one-third (31/87, 36%) had hyperbilirubinemia (serum total bilirubin >or=1.4 mg/dL) at initial presentation. The intervals between initiation of appropriate therapy to defervescence were longer in patients with hyperbilirubinemia than those without hyperbilirubinemia, irrespective of tetracycline or fluoroquinolone therapy. Of note, 8 (7.3%) cases experienced a prolonged period of fever (>28 days). In southern Taiwan, the predominant presentation of acute Q fever is acute febrile illness with hepatitis with or without jaundice. Acute Q fever should be added to the list of differential diagnoses of patients with fever, headache, relative bradycardia, elevated serum aminotransferase levels, or prolongation of activated partial thromboplastin time, irrespective of jaundice.
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PMID:Acute Q fever in southern Taiwan: atypical manifestations of hyperbilirubinemia and prolonged fever. 1794 35

We describe the cases of three children with encephalitis associated with Coxiella burnetii infection. Neurologic features ranged from status epilepticus and coma to headache and pseudotumor cerebri syndrome. Patients had good response to antibiotic treatment with doxycycline and recovered fully. Q fever should be included in the differential diagnosis of children with encephalitis, and routine serological testing should be considered, especially in endemic areas.
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PMID:Acute Q fever in children presenting with encephalitis. 1805 92


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