{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:45:02Z","timestamp":1790171102097,"version":"4.1.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T00:00:00Z","timestamp":1632355200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of this study was to describe the natural history of acute Q fever, including its clinical and serological evolution and progression to chronic Q fever.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Observational cohort study (January 2011\u2013September 2020) performed at Valme University Hospital (Seville, Spain). Inclusion criteria: (1) patients aged \u226518 years; (2) acute Q fever diagnosis, defined as suggestive symptoms in the presence of phase II immunoglobulin G (IgG) titer &amp;gt;1:256; (3) at least 6 months\u2019 follow-up after the acute Q fever episode. The incidence of seroconversion to a chronic Q fever serological pattern, defined as phase I IgG titers \u22651:1024 6 months after acute Q fever diagnosis, was assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, 117 patients were included. Thirty-four (29%) patients showed phase I IgG titers \u22651:1024 6 months after acute Q fever diagnosis. All patients with classic serological criteria for chronic Q fever diagnosis remained asymptomatic despite no specific treatment, with a median (quartile 1\u2013quartile 3 [Q1\u2013Q3]) follow-up of 26.5 (14\u201344) months in this subgroup. No cases of Q fever endocarditis nor other persistent focalized infection forms were observed during the study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A significant proportion of acute Q fever patients develop classic serological criteria for chronic Q fever diagnosis in the absence of additional data of chronic Q fever. Consequently, phase I IgG cutoff titers &amp;gt;1:800 should not be used as a criterion to consider such a diagnosis. The incidence of persistent focalized infection forms after acute Q fever is extremely low and does not justify the use of prophylaxis strategies.<\/jats:p><\/jats:sec>","DOI":"10.1093\/cid\/ciab843","type":"journal-article","created":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T19:17:07Z","timestamp":1632165427000},"page":"2122-2128","source":"Crossref","is-referenced-by-count":7,"title":["High Incidence of Asymptomatic Phase I IgG Seroconversion After an Acute Q Fever Episode: Implications for Chronic Q Fever Diagnosis"],"prefix":"10.1093","volume":"74","author":[{"given":"Miguel","family":"Rodr\u00edguez-Fern\u00e1ndez","sequence":"first","affiliation":[{"name":"Unidad de Enfermedades Infecciosas y Microbiolog\u00eda, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla , Seville , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinaldo","family":"Esp\u00edndola G\u00f3mez","sequence":"additional","affiliation":[{"name":"Unidad de Enfermedades Infecciosas y Microbiolog\u00eda, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla , Seville , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Trigo-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Unidad de Enfermedades Infecciosas y Microbiolog\u00eda, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla , Seville , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Castro","sequence":"additional","affiliation":[{"name":"Unidad de Enfermedades Infecciosas y Microbiolog\u00eda, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla , Seville , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Mart\u00ednez P\u00e9rez-Crespo","sequence":"additional","affiliation":[{"name":"Unidad de Enfermedades Infecciosas y Microbiolog\u00eda, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla , Seville , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roc\u00edo","family":"Herrero","sequence":"additional","affiliation":[{"name":"Unidad de Enfermedades Infecciosas y Microbiolog\u00eda, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla , Seville , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva M","family":"Le\u00f3n","sequence":"additional","affiliation":[{"name":"Unidad de Enfermedades Infecciosas y Microbiolog\u00eda, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla , Seville , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Bernal","sequence":"additional","affiliation":[{"name":"Unidad de Enfermedades Infecciosas y Microbiolog\u00eda, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla , Seville , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan E","family":"Corzo","sequence":"additional","affiliation":[{"name":"Unidad de Enfermedades Infecciosas y Microbiolog\u00eda, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla , Seville , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1120-8942","authenticated-orcid":false,"given":"Nicol\u00e1s","family":"Merchante","sequence":"additional","affiliation":[{"name":"Unidad de Enfermedades Infecciosas y Microbiolog\u00eda, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla , Seville , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,9,23]]},"reference":[{"key":"2022070618173214400_CIT0001","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1128\/CMR.12.4.518","article-title":"Q fever","volume":"12","author":"Maurin","year":"1999","journal-title":"Clin Microbiol Rev"},{"key":"2022070618173214400_CIT0002","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1093\/cid\/cir234","article-title":"Follow-up of 686 patients with acute Q fever and detection of chronic infection","volume":"52","author":"van der Hoek","year":"2011","journal-title":"Clin Infect Dis"},{"key":"2022070618173214400_CIT0003","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1086\/321889","article-title":"Risks factors and prevention of Q fever endocarditis","volume":"33","author":"Fenollar","year":"2001","journal-title":"Clin Infect Dis"},{"key":"2022070618173214400_CIT0004","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1128\/CVI.05724-11","article-title":"Microbiological challenges in the diagnosis of chronic Q fever","volume":"19","author":"Kampschreur","year":"2012","journal-title":"Clin Vaccine Immunol"},{"key":"2022070618173214400_CIT0005","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.3201\/eid2107.130955","article-title":"Chronic Q fever diagnosis\u2014consensus guideline versus expert opinion","volume":"21","author":"Kampschreur","year":"2015","journal-title":"Emerg Infect Dis"},{"key":"2022070618173214400_CIT0006","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1128\/cdli.1.2.189-196.1994","article-title":"Q fever serology: cutoff determination for microimmunofluorescence","volume":"1","author":"Dupont","year":"1994","journal-title":"Clin Diagn Lab Immunol"},{"key":"2022070618173214400_CIT0007","doi-asserted-by":"crossref","first-page":"350","DOI":"10.3201\/eid1703.100882","article-title":"Q fever in France, 1985-2009","volume":"17","author":"Frankel","year":"2011","journal-title":"Emerg Infect Dis"},{"key":"2022070618173214400_CIT0008","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.jinf.2011.12.014","article-title":"Chronic Q fever: review of the literature and a proposal of new diagnostic criteria","volume":"64","author":"Wegdam-Blans","year":"2012","journal-title":"J Infect"},{"key":"2022070618173214400_CIT0009","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.jinf.2012.04.006","article-title":"Chronic Q fever: expert opinion versus literature analysis and consensus","volume":"65","author":"Raoult","year":"2012","journal-title":"J Infect"},{"key":"2022070618173214400_CIT0010","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1093\/cid\/cit419","article-title":"Evolution from acute Q fever to endocarditis is associated with underlying valvulopathy and age and can be prevented by prolonged antibiotic treatment","volume":"57","author":"Million","year":"2013","journal-title":"Clin Infect Dis"},{"key":"2022070618173214400_CIT0011","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1007\/s15010-010-0052-x","article-title":"One-year follow-up of patients of the ongoing Dutch Q fever outbreak: clinical, serological and echocardiographic findings","volume":"38","author":"Limonard","year":"2010","journal-title":"Infection"},{"key":"2022070618173214400_CIT0012","doi-asserted-by":"crossref","first-page":"e0131848","DOI":"10.1371\/journal.pone.0131848","article-title":"Long-term serological follow-up of acute Q-fever patients after a large epidemic","volume":"10","author":"Wielders","year":"2015","journal-title":"PLoS One"},{"key":"2022070618173214400_CIT0013","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1016\/j.cmi.2021.03.016","article-title":"The prognostic value of serological titers for clinical outcomes during treatment and follow-up of patients with chronic Q fever","volume":"27","author":"Buijs","year":"2021","journal-title":"Clin Microbiol Inf"},{"key":"2022070618173214400_CIT0014","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.jinf.2013.10.010","article-title":"Reduction in incidence of Q fever endocarditis: 27 years of experience of a national reference center","volume":"68","author":"Edouard","year":"2014","journal-title":"J Infect"},{"key":"2022070618173214400_CIT0015","doi-asserted-by":"crossref","first-page":"e2810","DOI":"10.1097\/MD.0000000000002810","article-title":"Treatment and prophylactic strategy for Coxiella burnetii infection of aneurysms and vascular grafts: a retrospective cohort study","volume":"95","author":"Eldin","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"2022070618173214400_CIT0016","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1128\/CMR.00045-16","article-title":"From Q fever to Coxiella burnetii infection: a paradigm change","volume":"30","author":"Eldin","year":"2017","journal-title":"Clin Microbiol Rev"},{"key":"2022070618173214400_CIT0017","doi-asserted-by":"crossref","first-page":"4919","DOI":"10.1128\/JCM.42.11.4919-4924.2004","article-title":"Molecular detection of Coxiella burnetii in the sera of patients with Q fever endocarditis or vascular infection","volume":"42","author":"Fenollar","year":"2004","journal-title":"J Clin Microbiol"},{"key":"2022070618173214400_CIT0018","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.3201\/eid1108.041354","article-title":"Coxiella burnetii genotyping","volume":"11","author":"Glazunova","year":"2005","journal-title":"Emerg Infect Dis"},{"key":"2022070618173214400_CIT0019","first-page":"386","article-title":"Epidemiology of Q fever in Spain (2018)","volume":"31","author":"P\u00e9rez-Arellano","year":"2018","journal-title":"Rev Esp Quimioter"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciab843\/40909262\/ciab843.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/74\/12\/2122\/44479623\/ciab843.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/74\/12\/2122\/44479623\/ciab843.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T19:27:08Z","timestamp":1673292428000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/74\/12\/2122\/6374413"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,23]]},"references-count":19,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,9,23]]},"published-print":{"date-parts":[[2022,7,6]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciab843","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,6,15]]},"published":{"date-parts":[[2021,9,23]]}}}