Travel-associated Coxiella burnetii infections: three cases of Q fever with different clinical manifestation

BACKGROUND: Certain activities expose travellers to Coxiella burnetii, the causative agent of acute human Q fever. Awareness of Q fever must be improved, also as a potential imported disease, but delayed seroconversion and serological cross-reactivity complicate the diagnosis. Granulomatous inflammation of liver and bone marrow can be typical histopathological findings. CASE PRESENTATIONS: We present three imported cases of Q fever with different clinical presentations, in which the travel history identified the sources of infection. CONCLUSIONS: Q fever should be suspected in any imported febrile disease of unknown origin. Clinical manifestations are variable and repeated serological testing is mandatory. In some cases diagnostic biopsies might help to establish early diagnosis.