Q Fever in pregnancy: a case report and review of the literature

Endemic occurrence of Q fever among persons in close contact with domestic animals is well known in some rural regions of Germany. The prevalence of antibodies indicating acute Q fever in pregnancy reported in the literature varies between 0.2 % and 4.7 % of the screened population. Q fever in pregnancy initially manifests as placentitis and often leads to premature birth (30 %), growth restriction (46 %), spontaneous abortion (22 %) or fetal death in utero (7 %). Some impairment of pregnancy is observed in over 70 % of cases with seroconversion during pregnancy. Thus Q fever serology should be tested in all pregnant women presenting with atypical pneumonia and/or prolonged fever of unknown etiology. It is of interest that medical staff members in contact with Cociella burnetii infected pregnant women are also at risk of acquiring an acute Q fever infection. We report about a patient presenting with confirmed acute and later chronic Q fever during pregnancy in whom antibiotic treatment with rifampicin and clarithromycin proved to be effective and led to the vaginal delivery of a premature but healthy infant. We believe that maternal serum screening for transmissible infections should also include Q fever serology in certain rural regions.