<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0375-0760</journal-id>
<journal-title><![CDATA[Revista Cubana de Medicina Tropical]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Med Trop]]></abbrev-journal-title>
<issn>0375-0760</issn>
<publisher>
<publisher-name><![CDATA[Centro Nacional de Información de Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0375-07602019000200016</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Presentación de la fiebre Q simulando leptospirosis grave]]></article-title>
<article-title xml:lang="en"><![CDATA[Presentation of Q fever simulating severe leptospirosis]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lorenzo Villalba]]></surname>
<given-names><![CDATA[Noel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Suarez Ortega]]></surname>
<given-names><![CDATA[Saturnino]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hôpitaux Universitaires de Strasbourg Diabète et Maladies Métaboliques Service de Médecine Interne]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>France</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Universitario de Gran Canaria Dr. Negrin  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2019</year>
</pub-date>
<volume>71</volume>
<numero>2</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0375-07602019000200016&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0375-07602019000200016&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0375-07602019000200016&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN La fiebre Q aguda es una zoonosis ubicua, que habitualmente se presenta con cuadros febriles autolimitados. En presencia de un cuadro séptico con manifestaciones de disfunción multiórgano, hepatitis colestásica, distres respiratorio o la insuficiencia renal como semiología dominante y cultivos negativos se piensa habitualmente en leptospirosis. La alta prevalencia de fiebre Q en el Servicio de Medicina Interna del Hospital Universitario de Gran Canaria &#8220;Doctor Negrín&#8221;, que ha requerido evaluación hospitalaria -unos 50 casos al año en un área de 400 000 habitantes-, motivó la realización de serología para fiebre Q y leptospirosis en presencia de cuadros sépticos con cultivos negativos. De manera que se han encontrado durante los seis últimos años, tres casos de fiebre Q simulando leptospirosis. La rápida respuesta a la asociación de esteroides y doxiciclina ha sido el común denominador de estos tres casos. El contexto global con la rápida respuesta al tratamiento expuesto es el motivo de esta presentación.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT Acute Q fever is a ubiquitous zoonosis which often presents with self-limited febrile episodes. In the presence of a septic episode with manifestations of multiple organ dysfunction, cholestatic hepatitis, respiratory distress or renal failure as the prevailing semiology, and negative culture results, leptospirosis is usually suspected. The high prevalence of Q fever cases requiring evaluation at the Internal Medicine Service of Doctor Negrín University Hospital in Gran Canaria -about 50 cases per year in an area of 400 000 inhabitants- led to the indication of serological tests for Q fever and leptospirosis in septic cases with negative culture results. In the last six years, three cases have been found of Q fever simulating leptospirosis. A rapid response to the association of steroids and doxycycline was the common feature of these three cases. The study was aimed at describing the global context of the rapid response to the treatment indicated.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[fiebre Q]]></kwd>
<kwd lng="es"><![CDATA[sepsis]]></kwd>
<kwd lng="es"><![CDATA[disfunción multiórgano]]></kwd>
<kwd lng="es"><![CDATA[leptospirosis]]></kwd>
<kwd lng="en"><![CDATA[Q fever]]></kwd>
<kwd lng="en"><![CDATA[sepsis]]></kwd>
<kwd lng="en"><![CDATA[multiple organ dysfunction]]></kwd>
<kwd lng="en"><![CDATA[leptospirosis]]></kwd>
</kwd-group>
</article-meta>
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