Dorfman Karina, Eran Ayelet, Ghanem-Zoubi Nesrin
Radiology Department, Bnai-Zion Medical Center, Haifa, Israel.
Department of Radiology, Rambam Health Care Campus, Haifa, Israel.
Rambam Maimonides Med J. 2021 Jan 19;12(1):e0007. doi: 10.5041/RMMJ.10430.
Query (Q) fever is a zoonotic bacterial infection caused by Coxiella burnetii. In a minority of patients, chronic disease can occur after acute infection. Endocarditis and infections of aneurysms or vascular prostheses are the most common forms of chronic Q fever in adults. We report a case of an elderly female patient with chronic Q fever vertebral osteomyelitis at the site of her previous cement vertebroplasty, complicated by paravertebral abscess. Patient treatment required prolonged drainage in addition to the long duration of antibiotic treatment by doxycycline and hydroxychloroquine. Osteomyelitis is a rare clinical presentation in adults with chronic Q fever. However, it is important to consider Q fever in the differential diagnosis of culture-negative osteomyelitis, especially in countries where C. burnetii is endemic, such as Israel.
疑问热(Q热)是一种由伯氏考克斯体引起的人畜共患细菌感染。少数患者在急性感染后会发生慢性病。心内膜炎以及动脉瘤或血管假体感染是成人慢性Q热最常见的形式。我们报告一例老年女性患者,在其先前的骨水泥椎体成形术部位发生慢性Q热椎体骨髓炎,并伴有椎旁脓肿。患者的治疗除了需要强力霉素和羟氯喹进行长时间抗生素治疗外,还需要长时间引流。骨髓炎在成人慢性Q热中是一种罕见的临床表现。然而,在培养阴性骨髓炎的鉴别诊断中考虑Q热很重要,尤其是在伯氏考克斯体流行的国家,如以色列。