{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T10:28:40Z","timestamp":1787308120086,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":232,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Tropical Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Q fever, caused by\n                      <jats:italic>Coxiella burnetii<\/jats:italic>\n                      , is an underrecognized zoonotic infection with diverse clinical manifestations. The nonspecific nature and slow progression of Q fever frequently delay diagnosis, sometimes leading to severe or even fatal outcomes. This study describes 32 patients diagnosed with Q fever over an 18\u2010month period in a previously unreported region, highlighting the emerging awareness of this neglected zoonosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients with seropositive\n                      <jats:italic>C. burnetii<\/jats:italic>\n                      Phase I\/II IgM and\/or IgG antibodies between October 2023 and March 2025 (18\u2010month period) were included. Cases were classified as acute, probable, chronic, or past infection according to established serological and clinical criteria.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010two patients were diagnosed during the study period, of whom 22 (68.8%) were male; the median age was 60.5\u2009years (IQR: 48\u201366). More than half were farmers, and 40.6% reported animal exposure. Based on serological and clinical criteria, 11 patients were diagnosed with acute Q fever, 16 with probable infection, one with chronic infection, and four with past infection. Common manifestations included fever, myalgia, arthralgia, hepatitis, and endocarditis; cardiovascular involvement occurred in 40.6% of patients. Two patients died, and notably, three patients with prosthetic valve endocarditis had a history of care at the same cardiac surgery clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Given its heterogeneous clinical manifestations and variable serological responses, Q fever poses significant diagnostic challenges. This study presents the first and largest human case series of Q fever from the Black Sea region of T\u00fcrkiye, highlighting the wide clinical spectrum of the disease and the need for enhanced awareness and diagnostic capacity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jotm\/1628136","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T10:05:26Z","timestamp":1787306726000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Emerging Q Fever Infection in T\u00fcrkiye"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0277-5443","authenticated-orcid":false,"given":"Hatun","family":"\u00d6zt\u00fcrk \u00c7erik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1141-9838","authenticated-orcid":false,"given":"Arzu","family":"Altun\u00e7eki\u00e7 Y\u0131ld\u0131r\u0131m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4419-4508","authenticated-orcid":false,"given":"Celali","family":"Kurt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1935-9235","authenticated-orcid":false,"given":"\u00d6nder","family":"Erg\u00f6n\u00fcl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"e_1_2_15_1_2","volume-title":"Seminars in Respiratory and Critical Care Medicine","author":"Espa\u00f1a P. 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