@article{3004772,
    title = "Q fever in children in Greece",
    author = "Maltezou, H.C. and Constantopoulou, I. and Kallergi, C. and Vlahou, V. and Georgakopoulos, D. and Kafetzis, D.A. and Raoult, D.",
    journal = "The American Journal of Tropical Medicine and Hygiene",
    year = "2004",
    volume = "70",
    number = "5",
    pages = "540-544",
    publisher = "American Society of Tropical Medicine and Hygiene",
    issn = "0002-9637, 1476-1645",
    doi = "10.4269/ajtmh.2004.70.540",
    keywords = "antibiotic agent;  cefotaxime;  penicillin derivative, adolescent;  antibody titer;  article;  bacterial meningitis;  bacterial pneumonia;  cheese;  child;  child hospitalization;  clinical feature;  Coxiella burnetii;  dietary intake;  female;  fever;  Greece;  headache;  hemolytic uremic syndrome;  hepatitis;  human;  immunofluorescence test;  incidence;  infant;  infection risk;  laboratory test;  major clinical study;  male;  Q fever;  rickettsiosis;  risk factor;  rural area;  tick bite;  treatment outcome;  zoonosis, Acari;  Bacteria (microorganisms);  Coxiella burnetii;  Rickettsiales",
    abstract = "The aim of this study was to investigate the incidence, epidemiology, and clinical manifestations of Q fever among hospitalized children in Greece. During a two-year period, 1,200 children with various clinical manifestations were prospectively tested for Coxiella burnetii infection by indirect immunofluorescence. Acute Q fever was diagnosed in eight (0.67%) patients. No chronic case of infection was detected. Multivariate analysis showed that children 11-14 years old and children reporting consumption of cheese from rural areas were at increased risk for this illness. Clinical manifestations of acute Q fever were pneumonia (two patients), meningitis (two), prolonged fever (two), hepatitis (one), and hemolytic-uremic syndrome (one). Q fever accounted for 2.9% of the cases with prolonged fever, 1.2% of the cases of meningitis, and 0.5% of the cases of pneumonia. Fever and headache were the most common symptoms at presentation. Our study indicates that Q fever is a rare cause of hospitalization during childhood."
}