Coorey Craig Peter, James William, Manickavasagam Venkat, Chen Jason, Baweja Sanjeev
Department of Renal Medicine Lismore Base Hospital Lismore New South Wales Australia.
School of Medicine University of Western Sydney Campbelltown New South Wales Australia.
Clin Case Rep. 2024 Oct 21;12(10):e9473. doi: 10.1002/ccr3.9473. eCollection 2024 Oct.
Acute Coxiella burnetti (Q fever) infection is known to activate the autoimmune inflammatory response. We report a rare case of glomerulonephritis associated with the Coxiella infection. An elderly male first presented with recurrent fevers of unknown origin and was subsequently diagnosed with Q fever infection and treated with doxycycline. He represented 2 months later with an acute kidney injury and active urinary sediment. Renal biopsy demonstrated a mesangiopathic pattern with staining for both C1q and IgM, raising possibilities of infection-related glomerulonephritis, C1q nephropathy and lupus nephritis. This case demonstrates glomerulonephritis as a complication of Q fever infection and the differential diagnosis and workup up that needs to be considered in cases of chronic Q fever.
已知急性伯氏考克斯体(Q热)感染会激活自身免疫性炎症反应。我们报告了一例与考克斯体感染相关的罕见肾小球肾炎病例。一名老年男性最初出现不明原因的反复发热,随后被诊断为Q热感染并接受多西环素治疗。两个月后,他因急性肾损伤和活跃的尿沉渣再次就诊。肾活检显示为系膜病变模式,C1q和IgM均呈阳性染色,提示可能为感染相关性肾小球肾炎、C1q肾病和狼疮性肾炎。该病例表明肾小球肾炎是Q热感染的一种并发症,以及在慢性Q热病例中需要考虑的鉴别诊断和检查。