Pediatric Q Fever in a Rural Area in Kazakhstan: A Case Report

Abstract

Introduction: Q fever is a zoonotic disease with variable clinical manifestations and potentially fatal complications. Although the infection is rare, it is more common in rural areas where livestock are kept. Case Presentation: On December 18, 2022, a 10-month-old boy from a village in the Turkestan region of Kazakhstan was admitted to the hospital with a fever of 38.5 - 39.0°C, dry cough, and general weakness. An X-ray revealed signs of right-sided bronchopneumonia. The patient received empirical antibiotic treatment and corticosteroid therapy. Retrospective enzyme-linked immunosorbent assay (ELISA) tests demonstrated that his acute phase serum was positive for antibodies against Coxiella burnetii phase I antigens and negative for antibodies against C. burnetii phase II antigens. Considering the young age of the patient, which rules out a possible previous C. burnetii infection, along with the clinical presentation, epidemiological factors (such as the consumption of unpasteurized goat milk), and serological data, the child was retrospectively diagnosed with Q fever. He responded well to treatment with cefazolin. Conclusions: In Kazakhstan, medical personnel have a low suspicion of Q fever in patients, mainly due to low awareness and the non-specific symptoms of the infection. This study aims to demonstrate the importance of recognizing Q fever as a possible cause of illness in children in the southern region of Kazakhstan.