Bone marrow lesions in Q fever [letter]

Delsol, G; Pellegrin, M; Familiadès, J; Auvergnat, J.Ch.

doi:10.1182/blood.v52.3.637.637

Cited by 21 publications

(4 citation statements)

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“…In a recent study, we described 59 cases of lymphadenitis associated with C burnetii infection, among which 42% were associated with persistent focalized infection. [ 33 ] Moreover, we recently demonstrated that C burnetii may predispose to lymphomagenesis. [ 32 ] 18 F-FDG PET/CT is therefore a tool of choice for monitoring C burnetii lymphadenitis.…”

Section: Discussionmentioning

confidence: 99%

“…Bone marrow uptake was observed in both primary and persistent focalized infection and was associated in almost 50% of cases with spleen hypermetabolism, reflecting the lymphoid tropism of C burnetii . Bone marrow involvement during Q fever has been reported in cases of pancytopenia, hemophagocytic syndrome with aspects of doughnut granuloma, [ 19 , 33 ] and has also recently been described as a diffuse bone marrow 18 F-FDG PET/CT hypermetabolism. [ 20 , 34 ]…”

Section: Discussionmentioning

confidence: 99%

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18F-FDG PET/CT as a central tool in the shift from chronic Q fever to Coxiella burnetii persistent focalized infection

Eldin

Melenotte²,

Million

et al. 2016

Medicine

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

18F-FDG PET/CT as a central tool in the shift from chronic Q fever to Coxiella burnetii persistent focalized infection

Eldin

Melenotte²,

Million

et al. 2016

Medicine

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“…Bone marrow lesions usually correspond to granulomas sim-ilar to those found in the liver (59,74,150,254,333,343,386). Doughnut granulomas with macrophages, lymphocytes, polymorphonuclear leukocytes, and multinucleated giant cells surrounding a central clear space and a fibrinoid ring may also be found in bone marrow.…”

Section: Humansmentioning

confidence: 96%

Q Fever

1999

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SUMMARY Q fever is a zoonosis with a worldwide distribution with the exception of New Zealand. The disease is caused by Coxiella burnetii, a strictly intracellular, gram-negative bacterium. Many species of mammals, birds, and ticks are reservoirs of C. burnetii in nature. C. burnetii infection is most often latent in animals, with persistent shedding of bacteria into the environment. However, in females intermittent high-level shedding occurs at the time of parturition, with millions of bacteria being released per gram of placenta. Humans are usually infected by contaminated aerosols from domestic animals, particularly after contact with parturient females and their birth products. Although often asymptomatic, Q fever may manifest in humans as an acute disease (mainly as a self-limited febrile illness, pneumonia, or hepatitis) or as a chronic disease (mainly endocarditis), especially in patients with previous valvulopathy and to a lesser extent in immunocompromised hosts and in pregnant women. Specific diagnosis of Q fever remains based upon serology. Immunoglobulin M (IgM) and IgG antiphase II antibodies are detected 2 to 3 weeks after infection with C. burnetii, whereas the presence of IgG antiphase I C. burnetii antibodies at titers of ≥1:800 by microimmunofluorescence is indicative of chronic Q fever. The tetracyclines are still considered the mainstay of antibiotic therapy of acute Q fever, whereas antibiotic combinations administered over prolonged periods are necessary to prevent relapses in Q fever endocarditis patients. Although the protective role of Q fever vaccination with whole-cell extracts has been established, the population which should be primarily vaccinated remains to be clearly identified. Vaccination should probably be considered in the population at high risk for Q fever endocarditis.

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“…Finally, as we reported for Q fever endocarditis, the inflammatory reaction associated with Q fever aortitis lacks well‐formed granulomas. This observation suggests that patients with chronic Q fever could be unable to develop an effective cellular immune response against the bacterium, in contrast to that observed in the liver or bone marrow during acute Q fever [10–12].…”

Section: Discussionmentioning

confidence: 99%