Q Fever During Pregnancy Causes Abortion

[Gert van der Hoek]

Q Fever During Pregnancy

Diagnosis, Treatment, and Follow-up

Didier Raoult, MD, PhD; Florence Fenollar, MD; Andreas Stein, MD, PhD
Arch Intern Med. 2002;162:701-704.

Background Q fever, caused by Coxiella burnetii, may result in abortions, premature deliveries, and stillbirths in infected pregnant women.

Objective To evaluate the best treatment strategy for Q fever during pregnancy.

Methods We evaluated the prognosis of 17 pregnant women who developed Q fever with and without co-trimoxazole (trimethoprim-sulfamethoxazole) treatment.

Results The outcome of the pregnancy was found to depend on the trimester. Abortions occurred in 7 of 7 insufficiently treated patients infected during the first trimester vs 1 of 5 patients infected later. Co-trimoxazole given until delivery protected against abortion (0/4) but not against the development of chronic infections, and it did not significantly reduce the colonization of the placenta (2/4 vs 4/4).

Conclusions Our results show that C burnetii infections cause abortion and that women who develop Q fever while pregnant should be treated with co-trimoxazole for the duration of pregnancy, specifically when infected during the first trimester.

http://archinte.ama-assn.org/cgi/content/abstract/162/6/701?ijkey=070e95a891d83fffe07d0fb9683eadc15351ebf6&keytype2=tf_ipsecsha

[Gert van der Hoek]

Re: Q Fever During Pregnancy Causes Abortion

Snip from paper on Q-fever outbreak in Bulgaria and Slovakia:

Antibodies to phase II C. burnetii by MA were found in 16 of 18 aborting women with titers of 10 to 320, which indicates the possibility of acute Q-fever infection during pregnancy. In two cases, in paired sera collected in 23-day intervals, a shift from the titer of 160 to seronegativity (titer <10) was observed. Even though abortion tissues were not cultured or tested for C. burnetii, these findings deserve further study, since the possible adverse effects of C. burnetii infection during pregnancy has also been suggested by other authors (24).


24 - Stein A, Raoult D. Q fever and pregnancy in humans and animals. In: Kaz?r J, Toman R, editors. Rickettsiae and rickettsial diseases. Bratislava: VEDA; 1996. p. 551-7.

Q Fever in Bulgaria and Slovakia

http://www.cdc.gov/ncidod/eid/vol5no3/serbezov.htm#22

[Gert van der Hoek]

Re: Q Fever During Pregnancy Causes Abortion

Q fever during pregnancy: an emerging cause of
prematurity and abortion

Francisco Jover-D?az, Jaqueline Robert-Gates, Lucio Andreu-Gimenez,
and Jaime Merino-Sanchez
Internal Medicine Department, San Juan University Hospital, Alicante, Spain

Background: Although the pathogenic role of Coxiella burnetii infection during pregnancy is controversial, some
cases of stillbirth and abortion occurring after an acute or chronic infection have been mentioned in the literature.
Recently, Q fever has been advocated as a significant cause of morbidity and mortality in pregnancy.

Case: We describe an 18-year-old primipara woman admitted to our hospital for high fever and pancytopenia
during an acute C. burnetii infection. She was successfully treated with clarithromycin, overcoming fever and
pancytopenia. Finally, she gave birth to a healthy infant, and 1 year later both remained well.

Conclusion: Q fever is a potentially serious disease in pregnancy owing to the possibility of placenta infection and
fetal transmission affecting its outcome. Q fever infection should be suspected in unexplained febrile episodes or
abortion during pregnancy, when epidemiologic and clinical data are present.We believe that C. burnetii serology
should be tested in cases of fever of known origin or unexplained abortions, as the TORCH infections are.

Read the article: http://downloads.hindawi.com/journal...001/595797.pdf

[Gert van der Hoek]

Re: Q Fever During Pregnancy Causes Abortion

Thread on Q-fever and pregnancy ( Q koorts en zwangerschap) here:

http://www.flutrackers.com/forum/showthread.php?t=137683