Q-fever pneumonia in the Negev Region of Israel: A review of 20 patients hospitalised over a period of one year

Background: Three-hundred and forty-six patients with community acquired pneumonia were included in a prospective study of patients hospitalised over a 12-month period in the Soroka Medical Center in Beer-Sheva, Israel. Q-fever pneumonia (QFP) was diagnosed in 20 patients (5.8%). A detailed epidemiological and clinical description of this disease is presented. Methods: QFP was diagnosed by conventional criteria using a commercial immunofluorescent assay. Results: The age of patients was 41 ± 14 years (mean ± s.d., range 20-69). Twelve of the patients were males. No concomitant or chronic disease was present in 16 patients. Chest radiograms revealed alveolar or air space pneumonia in 10 patients, bronchopneumonia in nine and interstitial pneumonia in one patient. The mean febrile period was 10.5 ± 5.3 days. There was serological evidence of co-infection with Mycoplasma pneumoniae in six patients, and with Legionella pneumophila in one patient. Patients treated with β-lactam antibiotics recovered as quickly as those treated with tetracyclines or erythromycin. Conclusions: The Negev region of Israel is an endemic area for Q-fever. The diagnosis of QFP can be made only on the basis of a specific serological test. Clinical, radiologic or laboratory findings are not diagnostically definitive. The importance of specific therapy is unclear.