Open AccessReactivation of Q fever: case report of osteoarticular infection developing at the site of a soft tissue injury
Author(s) -
Genevieve McKew,
Thomas Gottlieb
Publication year - 2021
Publication title -
access microbiology
Language(s) - English
Resource type - Journals
ISSN - 2516-8290
DOI - 10.1099/acmi.0.000296
Subject(s) - medicine , soft tissue , serology , coxiella burnetii , q fever , doxycycline , osteomyelitis , septic arthritis , soft tissue injury , hydroxychloroquine , arthritis , chronic infection , surgery , dermatology , antibiotics , pathology , immunology , virology , antibody , immune system , disease , covid-19 , infectious disease (medical specialty) , microbiology and biotechnology , biology
Coxiella burnetii , the causative agent of Q fever, is known to cause acute and persistent infection, but reactivation of infection is rarely reported. This case demonstrates reactivation of a distant, untreated Q fever infection after a relatively innocuous soft tissue injury in an adjacent joint without pre-existing pathology. A 52-year-old male abbatoir worker sustained an adductor muscle tear in a workplace injury. He was unable to walk thereafter, and developed a chronic, progressive, destructive septic arthritis of the adjacent hip with surrounding osteomyelitis of the femur and acetabulum. He had evidence of prior Q fever infection, with a positive skin test and serology 15 years beforehand. He was diagnosed with chronic osteoarticular Q fever on the basis of markedly elevated phase I antibodies, and symptomatic and serological response to prolonged antibiotic treatment with doxycycline and hydroxychloroquine. He required a two-stage hip arthroplasty. This case illustrates reactivation of latent C. burnetii infection at the site of a soft tissue injury. Clinicians need to be aware of this possibility in patients with previous Q fever infection, and in the setting of undiagnosed osteoarticular pathology following soft tissue injury.