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Infection. 2016 Oct;44(5):677-82. doi: 10.1007/s15010-016-0884-0. Epub 2016 Mar 3.

A fatal case of disseminated chronic Q fever: a case report and brief review of the literature.

Author information

1
Division of Infectious Diseases 463, Department of Internal Medicine, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Stephan.Keijmel@radboudumc.nl.
2
Radboud Expert Centre for Q fever, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Stephan.Keijmel@radboudumc.nl.
3
Division of Infectious Diseases 463, Department of Internal Medicine, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
4
Radboud Expert Centre for Q fever, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
5
Department of Pathology, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.

Abstract

BACKGROUND:

Chronic Q fever is a rare infection, which mainly manifests as endocarditis, infection of vascular prostheses or aortic aneurysms. We present the case of a 74-year-old immunocompromised man with a haematologically disseminated Coxiella burnetii infection, which has never been reported before.

CASE REPORT:

He was diagnosed with a chronic Q fever infection of an aneurysm with an endovascular prosthesis in 2015, but he died despite optimal treatment. Autopsy revealed a disseminated C. burnetii infection, confirmed by a positive PCR on samples from several organs. Retrospectively, he already had complaints and signs of inflammation since 2012, for which he had already been admitted in February 2014. At that time, Q fever diagnostics using PCR, complement fixation assay, and enzyme-linked immunosorbent assay on serum were all negative. In retrospect however, retesting available samples from February 2014 using immunofluorescence assay (IFA) already revealed serology compatible with chronic Q fever.

CONCLUSION:

Clinicians should be aware of this silent killer, especially in case of risk factors, and perform an appropriate diagnostic work-up for Q fever including IFA serology and PCR.

KEYWORDS:

Chronic Q fever; Coxiella burnetii; Disseminated infection; Fatal; Q fever

PMID:
26940462
PMCID:
PMC5042989
DOI:
10.1007/s15010-016-0884-0
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

On behalf of all authors, the corresponding author states that there is no conflict of interest. The authors declare that the final manuscript has not been submitted or accepted for publication elsewhere. Consent Written informed consent for publication of the clinical details and images was obtained from the patient’s spouse.

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