To the Editor.—We agree with Musher1 that physicians need to be reminded of the importance and occurrence of Q fever in endemic areas, as well as in urban hospitals where its occurrence may not be so frequent.
We have reviewed our experience with 38 patients who had acute Q fever and were cared for at our hospital in the last 7 years. The Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, is a 900-bed community hospital located downtown, and provides health care for an estimated population of 530 000. There were 35 men (92.1%) and 3 women (7.9%). All the patients represented sporadic cases. The majority of our patients (34[89.5%]) were living in Barcelona and 4 of them (10.5%) reported having visited the countryside. Twenty-one cases (55.2%) occurred during spring. Eighteen patients (47.3%) presented with clinical and roentgenographic features consistent with pneumonia, whereas 16 patients (42.1%) had