Q fever vertebral osteomyelitis among adults: a case series and literature review

Ghanem-Zoubi, Nesrin; Karram, Tony; Kagna, Olga; Merhav, Goni; Keidar, Zohar; Paul, Michal

doi:10.1080/23744235.2020.1871508

Cited by 10 publications

(12 citation statements)

References 31 publications

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“…Spinal infection in chronic Q fever is much rare especially for isolated spinal infection without history of vascular disease and intervention [9]. As of now, only eleven cases of isolated spinal infection from Coxiella burnetii except for us have been reported from a recent literature review spanning 1990-2020 performed by Ghanem-Zoubi et al [10]. Both our case report and all other studies suggest that non-specific symptom of this rare infection makes it a diagnostic challenge, and the duration of initial symptoms until diagnosis is long varying from several months up to few years in general that often resulting in aggravation for misdiagnosis and delayed treatment [11,12].…”

Section: Discussionmentioning

confidence: 99%

Spinal infection caused by Coxiella burnetii

Yang

Bai

et al. 2023

BMC Infect Dis

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Background Spinal infection caused by Coxiella burnetii is rare and difficult to diagnose. Here we reported a case of spinal infection from Coxiella burnetii detected by the metagenomic next-generation sequencing (mNGS). Case presentation A 66-year-old male farmer with no medical history reported severe sharp low back pain, numbness and lower limb weakness for three years. Magnetic resonance imaging (MRI) revealed bone destruction and spinal cord compression within L1 and L2. mNGS testing showed that the inspected specimen collected from spinal lesion was detected positively for Coxiella burnetii. After receiving the combined treatment of antibiotic therapy and surgical intervention, the patient recovered well, and the sagittal MRI showed that vertebral edema signals disappeared and the graft of bone fused 16 months after surgery. Conclusion The mNGS may be benefit for early diagnosis and intervention of non-specific spinal infection, and future studies should validate its effectiveness for clinical use in spinal infections. Additionally, antibiotic therapy combined with surgical intervention plays an important role on the treatment of spinal infection caused by Coxiella burnetii.

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Section: Discussionmentioning

confidence: 99%

Spinal infection caused by Coxiella burnetii

Yang

Bai

et al. 2023

BMC Infect Dis

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“…Q fever should be included in the differential diagnosis of vertebral osteomyelitis in endemic settings, in particular if vascular infection is identified. Imaging-guided aspiration and surgical drainage pose additional risks but in complex cases may be the only way to control the source of pyogenic infection [ 3 ] .…”

Section: Discussionmentioning

confidence: 99%

“…Less than 1% of cases evolve to chronic disease and present as bone infection [2] . Chronic osteomyelitis in Q fever has an insidious evolution, presents histological evidence of granulomatous inflammation, and lacks evidence of the presence of alternate microorganisms, including mycobacteria [3] . Diagnostic reference methods include serological and polymerase chain reaction tests [4] .…”

Section: Introductionmentioning

confidence: 99%

“…Chronic osteomyelitis in Q fever has an insidious evolution, presents histological evidence of granulomatous inflammation, and lacks evidence of the presence of alternate microorganisms, including mycobacteria [ 3 ] .…”

Section: Introductionmentioning

confidence: 99%

“…Treatment includes doxycycline and other regimens including quinolones [ 4 ] . Given the challenges of vertebral pyogenic infection, surgical drainage presents additional difficulties [ 3 ] .…”

Section: Introductionmentioning

confidence: 99%

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Q Fever Spondylodiscitis: A Rare Manifestation of a Challenging Disease

Gomes

Carlos

Faísca

et al. 2022

European Journal of Case Reports in Internal Medicine

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Coxiella burnetii causes Q fever, which is found worldwide and can be acute or chronic. This case report describes a 72-year-old man whose bilateral lower limb pain revealed a paravertebral abscess at L2–L3 due to Q fever spondylodiscitis. Surgical drainage of the abscess was performed and medical treatment is ongoing. Q fever is endemic in Portugal and transmitted by inhalation of aerosols containing spores from infected animals (cattle, goats and sheep) or by ingesting cottage cheese or unpasteurized milk. It has an incubation period of 2–3 weeks and 60% of patients are asymptomatic with only 2% needing hospitalization. Primary infection can manifest in any organ and most cases are self-limiting (self-limited febrile illness, atypical pneumonia or acute hepatitis). Less than 1% of cases evolve to chronic disease, presenting as osteomyelitis or endocarditis. Chronic disease poses a diagnostic challenge and spondylodiscitis has an insidious evolution. Diagnosis requires microbiological and clinical confirmation. Serological and polymerase chain reaction tests are used for diagnosis. <br/> Acute disease is usually treated with doxycycline for 3 weeks to avoid evolution to chronic disease. Chronic disease requires 18–24 months of doxycycline with hydroxychloroquine. Acute disease can recur so follow-up is essential as chronic Q fever can result in morbidity and mortality. In Portugal Q fever is a notifiable disease due to the epidemiological risk.

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