Coxiella (Q fever)‐associated myelopathy

Abstract

We describe six men with a slowly progressive myelopathy characterized by asymmetric, incomplete spinal cord syndrome manifested with a thoracic sensory level, mild spastic paraparesis, and urinary incontinence. The spinal cord lesions were evident by MRI in four of them. Coxiella burnetii infection was confirmed in the blood of all patients by immunofluorescence microscopic assay (IFA) and transmission electron microscopy (TEM). In two patients, we detected C burnetii by TEM and IFA using CSF from the patients inoculated onto fresh peripheral blood lymphocyte. Four patients, treated with appropriate antibiotics, responded either with partial resolution of symptoms or arrest of further neurologic progression. In three, the MRI lesions decreased in size.

From Q Fever to Coxiella burnetii Infection: a Paradigm Change

“…Our team has recently demonstrated that C. burnetii infection is associated with an increased risk of lymphoma (334). Before that study, 22 cases of lymphoproliferative disease in the context of Q fever were available in the literature (621)(622)(623)(624). A patient who was followed in our center for a C. burnetii vascular infection was diagnosed with B-cell lymphoma, and C. burnetii was detected in the lymphoma tissue.…”

Acute transverse myelitis associated with coxiella burnetii infection

“…The potential of C. burnetii triggering CNS immune reactivity has first been noted in two reports documenting the development of optic neuritis in the course of Q-fever [7,8]. The potential tropism of C. burnetii (or its accompanying immunological reactions) to the spinal cord is further substantiated by one single report of chronic myelopathy associated with Q-fever [3]. Here, in six patients with slowly progressive myelopathy C. burnetii was demonstrated by culturing the agent from peripheral blood lymphocytes.…”

“…Partial recovery or the arrest of further neurologic deterioration was seen after treatment with appropriate antibiotics. However, the detection of the organism in the CSF succeeded in only 2 of the 6 reported cases [3]. Normal CSF findings are typical for Q-fever [6].…”

Mononeuritis multiplex caused by Coxiella burnetii infection (Q fever)

“…The typical clinical manifestations are a self‐limited febrile illness with fatigue, chills and headaches, atypical pneumonia, hepatitis and endocarditis (1). Neurologic complications are rare and range from meningoencephalitis, cerebellitis, extrapyramidal signs, myelopathy, optic neuritis to Guillain Barré syndrome and Miller Fisher syndrome (1–7).…”