{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:40:16Z","timestamp":1756363216560,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,8,2]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>A 29-year-old gravida 2 para 1 woman presented at 29 weeks gestation with fevers, back pain, thrombocytopenia and hepatitis. PCR testing of blood samples detected <jats:italic>Coxiella burnetii<\/jats:italic> and paired serology later confirmed the diagnosis of acute Q fever in pregnancy. The patient was treated empirically with oral clarithromycin and experienced a symptomatic and biochemical improvement. Therapy was changed to oral trimethoprim\/sulphamethoxazole but was complicated by a delayed cutaneous reaction, prompting recommencement of clarithromycin. Therapy continued until delivery of a healthy girl at 39 weeks and 3\u2009days. Q fever in pregnancy is likely under-reported and is associated with the development of chronic infection and obstetric complications. Treatment with clarithromycin is an alternative to trimethoprim\/sulphamethoxazole in the setting of drug intolerance.<\/jats:p>","DOI":"10.1136\/bcr-2021-242558","type":"journal-article","created":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T12:55:17Z","timestamp":1628859317000},"page":"e242558","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Acute Q fever in third trimester pregnancy"],"prefix":"10.1136","volume":"14","author":[{"given":"Maxwell","family":"Braddick","sequence":"first","affiliation":[{"name":"Infectious Diseases, Townsville Hospital and Health Service, Townsville, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1094-9853","authenticated-orcid":false,"given":"Marion L","family":"Woods","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Townsville Hospital and Health Service, Townsville, Queensland, 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