Q-FEVER PNEUMONIA IN THE NEGEV REGION OF ISRAEL - A REVIEW OF 20 PATIENTS HOSPITALIZED OVER A PERIOD OF ONE-YEAR

Background: Three-hundred and forty-six patients with community acquir ed pneumonia were included in a prospective study of patients hospital ised 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 i s presented. Methods: OFP was diagnosed by conventional criteria using a commercial immunofluorescent assay. Results: The age of patients wa s 41 +/- 14 years (mean +/- S.D., range 20-69). Twelve of the patients were males. No concomitant or chronic disease was present in 16 patie nts. Chest radiograms revealed alveolar or air space pneumonia in 10 p atients, brochopneumonia in nine and interstitial pneumonia in one pat ient. The mean febrile period was 10.5 +/- 5.3 days. There was serolog ical evidence of co-infection with Mycoplasma pneumoniae in six patien ts, and with Legionella pneumophila in one patient. Patients treated w ith beta-lactam antibiotics recovered as quickly as those treated with tetracyclines or erythromycin. Conclusions: The Negev region of Israe l is an endemic area for Q-fever. The diagnosis of QFP can be made onl y on the basis of a specific serological test. Clinical, radiologic or laboratory findings are not diagnostically definitive. The importance of specific therapy is unclear.