{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:47:38Z","timestamp":1762508858580,"version":"build-2065373602"},"reference-count":45,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T00:00:00Z","timestamp":1667174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>The World Health Organization (WHO) recently alerted the emergence of new pathogens causing acute hepatitis in children across several countries. This new situation directs us to the screening of neglected pathogens that cause acute hepatitis. Q-fever is a zoonotic disease, caused by Coxiella burnetii. Although a high seroprevalence of Coxiella burnetii was recorded in animals present in Egypt, Q-fever is still a neglected disease, and the diagnosis of Q-fever is not routinely performed in Egyptian hospitals. In this study, we performed a retrospective assessment for Coxiella burnetii in cases of hepatitis of unknown causes (HUC) enrolled in Assiut University hospitals, in Egypt. Out of 64 samples of HUC, 54 samples were negative for all hepatitis markers, labeled as acute hepatitis of unknown etiology (AHUE), and 10 samples tested positive for adenovirus and Hepatitis E virus (HEV). Q-fever was detected in 3 out of 54 (5.6%) of AHUE, and one sample was confirmed as coinfection of HEV\/Q-fever. Jaundice was the most common clinical symptom developed in the patients. In conclusion, Coxiella burnetii was found to be a potential cause of acute hepatitis in HUC. The diagnosis of Q-fever should be considered in acute hepatitis cases in Egyptian hospitals.<\/jats:p>","DOI":"10.3390\/microorganisms10112168","type":"journal-article","created":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T06:01:28Z","timestamp":1667282488000},"page":"2168","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The First Report of Coxiella burnetii as a Potential Neglected Pathogen of Acute Hepatitis of Unknown Causes in Egypt"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1943-8419","authenticated-orcid":false,"given":"Mohamed A.","family":"El-Mokhtar","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8207-6401","authenticated-orcid":false,"given":"Ibrahim M.","family":"Sayed","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayat M.","family":"Kamel","sequence":"additional","affiliation":[{"name":"Microbiology and Immunology Department, Faculty of Pharmacy, Assiut University, Assiut 71515, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4605-2976","authenticated-orcid":false,"given":"Ahmed Atef","family":"Mesalam","sequence":"additional","affiliation":[{"name":"Department of Therapeutic Chemistry, Pharmaceutical and Drug Industries Research Institute, National Research Centre (NRC), Cairo 12622, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elsayed A.","family":"Elgohary","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaled Abo bakr","family":"Khalaf","sequence":"additional","affiliation":[{"name":"Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2483-4715","authenticated-orcid":false,"given":"Sara","family":"Adel","sequence":"additional","affiliation":[{"name":"Clinical Pathology Department, Faculty of Medicine Al-Azhar University-Assiut Branch, Assiut 71515, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azza Abo","family":"Elfadl","sequence":"additional","affiliation":[{"name":"Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut 71515, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walaa A.","family":"Khalifa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut 71515, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0627-3985","authenticated-orcid":false,"given":"Haidi Karam-Allah","family":"Ramadan","sequence":"additional","affiliation":[{"name":"Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,31]]},"reference":[{"key":"ref_1","unstructured":"WHO (2022, October 01). 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