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

Intern Med. 2004 Jan;43(1):49-54. doi: 10.2169/internalmedicine.43.49.

Abstract

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.

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.

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.

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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Bacterial / analysis
  • Coxiella burnetii / drug effects
  • Coxiella burnetii / isolation & purification*
  • DNA, Bacterial / analysis
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Fatigue Syndrome, Chronic / complications
  • Fatigue Syndrome, Chronic / diagnosis
  • Fatigue Syndrome, Chronic / drug therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Japan
  • Long-Term Care
  • Male
  • Minocycline / administration & dosage*
  • Polymerase Chain Reaction
  • Probability
  • Q Fever / complications
  • Q Fever / diagnosis
  • Q Fever / drug therapy*
  • Risk Assessment
  • Statistics, Nonparametric
  • Treatment Outcome

Substances

  • Antibodies, Bacterial
  • DNA, Bacterial
  • Minocycline