Abstract

Coxiella burnetii infection (Q fever) in rheumatoid arthritis patients with and without anti-TNFα therapy Q fever is a zoonosis caused by the intracellular bacterium Coxiella burnetii. The Netherlands experienced a major Q fever outbreak between 2007 and 2010, with an estimate of more than 40 000 infected individuals.1 Initial infection is asymptom-atic in over 50 % of the infected individuals or causes a mostly self-limiting febrile disease.2 However, chronic Q fever may develop months to years after initial infection. This serious, life-threatening condition presents mostly as endocarditis or infec-tion of an aortic aneurysm or vascular prosthesis, and is accom-panied by high IgG antibody titres against phase I C burnetii.3 Individuals most at risk for chronic Q fever are those with pre-existing valvulopathy, vascular aneurysm or prosthesis and yet