Acute Q fever as a cause of acute febrile illness of unknown origin in Taiwan: Report of seven cases

Acute Q fever, caused by Coxiella burnetii has been well documented in Western countries, but only recently identified in Taiwan. Seven cases diagnosed by indirect fluorescent antibodies to phase II antigens of C. burnetii are reported. The patients were all men and a history of animal contact could be traced in most cases. Clinical manifestations were high fever, chills, relative bradycardia and elevated serum aminotransferases. Therapy with tetracycline or clarithromycin resulted in defervescence within 96 hours. Combining the knowledge on the prevalence of Q fever in Taiwan, the typical exposure history and clinical features in acute Q fever infection, primary care physicians may be able to avoid invasive but futile diagnostic intervention for patients with prolonged febrile illness. Prior to results from serologic testing, empiric therapy with tetracycline or its analogs may be considered for patients with typical clinical manifestations.