Niu Xinxin, Qiu Shuang, Zheng Yafeng, Li Li, Tian Eryun, Liu Jie, Gai Wei, Zhang Qing, Jin Hailong
Department of Organ Transplantation, The Third Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China.
WillingMed Technology (Beijing) Co., Ltd, Beijing, People's Republic of China.
Infect Drug Resist. 2025 Jan 3;18:25-30. doi: 10.2147/IDR.S485083. eCollection 2025.
Q fever is a zoonotic disease caused by the Gram-negative bacterium , typically transmitted through exposure to infected animal secretions. As the clinical signs of Q-fever are largely non-specific in humans, a definitive diagnosis can often be overlooked, particularly when physicians fail to consider on the list of differentials. This case report describes Q-fever in a male patient who had previously undergone orthotopic liver transplantation. The patient had a sudden onset of fever and received the anti-infective moxifloxacin which proved ineffective. Despite the comprehensive laboratory tests and CT imaging that were performed, the etiology remained undetermined. The patient's blood was subjected to metagenomic next-generation sequencing (mNGS), which identified , after which the patient was treated with doxycycline and recovered well. Eight literature articles on Q fever infection in solid organ transplant recipients were reviewed. To our knowledge, this is the first case of Q fever identified by mNGS in an organ transplantation patient. The case underscores the potential of mNGS has in aiding the rapid detection of rare pathogens in immunocompromised patients.
Q热是一种由革兰氏阴性菌引起的人畜共患病，通常通过接触受感染动物的分泌物传播。由于Q热在人类中的临床症状大多不具有特异性，因此确诊往往会被忽视，尤其是当医生没有将其列入鉴别诊断清单时。本病例报告描述了一名曾接受原位肝移植的男性患者的Q热。患者突然发热，接受抗感染药物莫西沙星治疗，但证明无效。尽管进行了全面的实验室检查和CT成像，病因仍未确定。对患者的血液进行了宏基因组下一代测序（mNGS），结果鉴定出了病原体，随后患者接受强力霉素治疗并恢复良好。我们查阅了8篇关于实体器官移植受者Q热感染的文献。据我们所知，这是首例通过mNGS在器官移植患者中确诊的Q热病例。该病例强调了mNGS在帮助快速检测免疫功能低下患者中罕见病原体方面的潜力。
