[Splenic abscess caused by Coxiella burnetti in the absence of endocarditis].

INTRODUCTION

The most frequent clinical expression of chronic Q fever is culture-negative endocarditis. Other localizations are rare.

EXEGESIS

We report a documented case of chronic Q fever that occurred in a 47-year-old immunocompetent man and was associated with spleen abscess, in the absence of detectable endocarditis. The spleen abscess was a complication of either a preexisting cyst or a calcified hematoma. Splenic infection with Coxiella burnetii was documented with cultures, polymerase chain reaction and immunohistochemistry. The outcome was favorable after splenectomy and a 21-month antibiotherapy.

CONCLUSION

Chronic Q fever may develop in the absence of endocarditis, when a preexisting vascular lesion such as aortic aneurysm exists. A splenic cyst may have played a similar role for this patient.