{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T14:29:27Z","timestamp":1792506567103,"version":"4.5.0"},"reference-count":26,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2014,5,1]],"date-time":"2014-05-01T00:00:00Z","timestamp":1398902400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            <jats:named-content content-type=\"genus-species\">Coxiella burnetii<\/jats:named-content>\n            causes Q fever, a zoonosis, which has acute and chronic manifestations. From 2007 to 2010, the Netherlands experienced a large Q fever outbreak, which has offered a unique opportunity to analyze chronic Q fever cases. In an observational cohort study, baseline characteristics and clinical characteristics, as well as mortality, of patients with proven, probable, or possible chronic Q fever in the Netherlands, were analyzed. In total, 284 chronic Q fever patients were identified, of which 151 (53.7%) had proven, 64 (22.5%) probable, and 69 (24.3%) possible chronic Q fever. Among proven and probable chronic Q fever patients, vascular infection focus (56.7%) was more prevalent than endocarditis (34.9%). An acute Q fever episode was recalled by 27.0% of the patients. The all-cause mortality rate was 19.1%, while the chronic Q fever-related mortality rate was 13.0%, with mortality rates of 9.3% among endocarditis patients and 18% among patients with a vascular focus of infection. Increasing age (\n            <jats:italic>P<\/jats:italic>\n            = 0.004 and 0.010), proven chronic Q fever (\n            <jats:italic>P<\/jats:italic>\n            = 0.020 and 0.002), vascular chronic Q fever (\n            <jats:italic>P<\/jats:italic>\n            = 0.024 and 0.005), acute presentation with chronic Q fever (\n            <jats:italic>P<\/jats:italic>\n            = 0.002 and\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001), and surgical treatment of chronic Q fever (\n            <jats:italic>P<\/jats:italic>\n            = 0.025 and\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001) were significantly associated with all-cause mortality and chronic Q fever-related mortality, respectively.\n          <\/jats:p>","DOI":"10.1128\/jcm.03221-13","type":"journal-article","created":{"date-parts":[[2014,3,6]],"date-time":"2014-03-06T05:33:33Z","timestamp":1394084013000},"page":"1637-1643","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":123,"title":["Chronic Q Fever in the Netherlands 5 Years after the Start of the Q Fever Epidemic: Results from the Dutch Chronic Q Fever Database"],"prefix":"10.1128","volume":"52","author":[{"given":"Linda M.","family":"Kampschreur","sequence":"first","affiliation":[{"name":"Division of Medicine, Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht, the Netherlands"},{"name":"Department of Internal Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corine E.","family":"Delsing","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf H. H.","family":"Groenwold","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolijn C. A.","family":"Wegdam-Blans","sequence":"additional","affiliation":[{"name":"Laboratory for Medical Microbiology, PAMM Foundation, Veldhoven, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal P.","family":"Bleeker-Rovers","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique G. L.","family":"de Jager-Leclercq","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Bernhoven Hospital, Uden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy I. M.","family":"Hoepelman","sequence":"additional","affiliation":[{"name":"Division of Medicine, Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjo E.","family":"van Kasteren","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, St. Elisabeth Hospital, Tilburg, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Buijs","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Atrium Medical Centre, Heerlen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole H. M.","family":"Renders","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marrigje H.","family":"Nabuurs-Franssen","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Jelrik","family":"Oosterheert","sequence":"additional","affiliation":[{"name":"Division of Medicine, Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Wever","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.12.4.518"},{"key":"e_1_3_2_3_2","first-page":"408","article-title":"Acute Q fever related in-hospital mortality in the Netherlands","volume":"68","author":"Kampschreur LM","year":"2010","unstructured":"KampschreurLMWegdam-BlansMCThijsenSFGrootCASchneebergerPMHollanderAASchijenJHArentsNLOosterheertJJWeverPC. 2010. 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