Improvement of Chronic Nonspecific Symptoms by Long-term Minocycline Treatment in Japanese Patients with Coxiella burnetii Infection Considered to Have Post-Q Fever Fatigue Syndrome

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  • ARASHIMA Yasutomo
    Department of Laboratory Medicine, Nihon University School of Medicine
  • KATO Kimitoshi
    Third Department of Internal Medicine, Nihon University School of Medicine
  • KOMIYA Tomoyoshi
    Department of Research and Development, Research Center for Biologicals, The Kitasato Institute
  • KUMASAKA Kazunari
    Department of Laboratory Medicine, Nihon University School of Medicine
  • MATSUKAWA Yoshihiro
    First Department of Internal Medicine, Nihon University School of Medicine
  • MURAKAMI Masato
    First Department of Internal Medicine, Nihon University School of Medicine
  • TAKAHASHI Katsuyuki
    Clinical Laboratory Department, Nihon University School of Medicine
  • IKEDA Tadao
    Department of Biology, Nihon University School of Medicine
  • ARAKAWA Yasuyuki
    Third Department of Internal Medicine, Nihon University School of Medicine

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Other Title
  • Various Clinical Types of Q-fever Disease

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Objective  To address the presence of post-Q fever fatigue syndrome (post-QFS) in Japan, and to evaluate the efficacy of minocycline for this condition.<BR>  Patients and Methods  In 20 Coxiella burnetii (C. burnetii) seropositive patients with persistent nonspecific symptoms including general fatigue, low-grade fever, myalgia and arthralgia, changes in subjective symptoms, C. burnetii antibody titers and C. burnetii DNA were evaluated after antibiotic treatment.<BR>  Results  After treatment mainly with minocycline (100 mg/day for 3 months), the clinical picture improved in all 20 patients as evidenced by decreases in body temperature (13/17), general fatigue (20/20) and headache (9/12). The mean performance status (PS) score improved from 5.0 to 1.8 (p<0.01). All 7 who had been positive for C. burnetii DNA, became negative together with an improvement in subjective symptoms. Indirect immunofluorescence tests demonstrated 6 of the 20 patients to be positive for C. burnetii IgM antibody to phase II antigen (1:32), and 18 to be positive for IgG antibody (1:128, 1:256). Antibody titers of both IgM (6/6, 1:16) and IgG (18/18, 1:16) decreased markedly after treatment.<BR>  Conclusion  These results of an open label study in Japan suggest that minocycline administration is useful for improving chronic nonspecific symptoms considered to be post-Q fever fatigue syndrome caused by C. burnetii infection.

Journal

  • Internal Medicine

    Internal Medicine 43 (1), 49-54, 2004

    The Japanese Society of Internal Medicine

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