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Long-term persistence of Coxiella burnetii in the host after primary Q fever

Published online by Cambridge University Press:  01 June 2000

R. J. HARRIS
Affiliation:
School of Pharmacy and Medical Sciences, University of South Australia
P. A. STORM
Affiliation:
Department of Pathology, University of Adelaide, Adelaide 5000, Australia
A. LLOYD
Affiliation:
Department of Pathology, University of New South Wales, Sydney NSW
M. ARENS
Affiliation:
Gastroenterological Medicine, Royal Adelaide Hospital
B. P. MARMION
Affiliation:
Department of Pathology, University of Adelaide, Adelaide 5000, Australia Institute of Medical and Veterinary Science
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Abstract

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After a primary infection Coxiella burnetii may persist covertly in animals and recrudesce at parturition to be shed in the products of conception and the milk. Similar latent persistence and recrudescence occurs in man: namely, infection of placenta, heart valve or mural endocardium, bone or liver. The numbers of organisms, their viability and cellular form, and the underlying organ sites of latent infection for the coxiella are obscure. During investigations of 29 patients with a chronic sequel to acute Q fever, the post-Q fever fatigue syndrome (QFS) [1–3], sensitive conventional and TaqMan-based PCR revealed low levels of C. burnetii DNA in blood mononuclear cells (5/29; 17%), thin needle liver biopsies (2/14; 14%) and, notably, in bone marrow aspirates (13/20; 65%). Irrespective of the ultimate significance of coxiella persistence for QFS, the detection of C. burnetii genomic DNA in bone marrow several years after a primary infection unveils a new pathological dimension for Q fever.

Type
Research Article
Copyright
© 2000 Cambridge University Press