Molecular detection of Coxiella burnetii from the formalin-fixed tissues of Q fever patients with acute hepatitisopen access
- Authors
- Jang, Young-Rock; Shin, Yong; Jin, Choong Eun; Koo, Bonhan; Park, Se Yoon; Kim, Min-Chul; Kim, Taeeun; Chong, Yong Pil; Lee, Sang-Oh; Choi, Sang-Ho; Kim, Yang Soo; Woo, Jun Hee; Kim, Sung-Han; Yu, Eunsil
- Issue Date
- Jul-2017
- Publisher
- PUBLIC LIBRARY SCIENCE
- Citation
- PLOS ONE, v.12, no.7
- Journal Title
- PLOS ONE
- Volume
- 12
- Number
- 7
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/73656
- DOI
- 10.1371/journal.pone.0180237
- ISSN
- 1932-6203
- Abstract
- Background Serologic diagnosis is one of the most widely used diagnostic methods for Q fever, but the window period in antibody response of 2 to 3 weeks after symptom onset results in significant diagnostic delay. We investigated the diagnostic utility of Q fever PCR from formalinfixed liver tissues in Q fever patients with acute hepatitis. Methods We reviewed the clinical and laboratory data in patients with Q fever hepatitis who underwent liver biopsy during a 17-year period, and whose biopsied tissues were available. We also selected patients who revealed granuloma in liver biopsy and with no Q fever diagnosis within the last 3 years as control. Acute Q fever hepatitis was diagnosed if two or more of the following clinical, serologic, or histopathologic criteria were met: (1) an infectious hepatitislike clinical feature such as fever (>= 38 degrees C) with elevated hepatic transaminase levels; (2) exhibition of a phase II immunoglobulin G (IgG) antibodies titer by IFA of >= 1:128 in single determination, or a four-fold or greater rise between two separate samples obtained two or more weeks apart; (3) histologic finding of biopsy tissue showing characteristic fibrin ring granuloma. Results A total of 11 patients with acute Q fever hepatitis were selected and analyzed. Of the 11 patients, 3 (27%) had exposure to zoonotic risk factors and 7 (63%) met the serologic criteria. Granulomas with either circumferential or radiating fibrin deposition were observed in 10 cases on liver biopsy and in 1 case on bone marrow biopsy. 8 (73%) revealed positive Coxiella burnetii PCR from their formalin-fixed liver tissues. In contrast, none of 10 patients with alternative diagnosis who had hepatic granuloma revealed positive C. burnetii PCR from their formalin-fixed liver tissues. Conclusions Q fever PCR from formalin-fixed liver tissues appears to be a useful adjunct for diagnosing Q fever hepatitis.
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