title: Rapidly fatal Q-fever pneumonia in a patient with chronic granulomatous disease.
abstract: Acute Q-fever is a systemic illness which rarely has a fatal outcome. Fatal cases do occur with the chronic form of the disease and associated with endocarditis. This report presents the case of a fatal, acute Q-fever pneumonia in an 11-year-old patient with chronic granulomatous disease. Complement fixation antibody titer rose to 1:1,024 with positive IgM in immunofluorescence. Giemsa stained lung sections and indirect immunofluorescence demonstrated the microorganisms in the tissues. The Coxiella burnetii infection was probably contracted during a holiday trip to rural France. Despite the fact that the patient received a variety of antimicrobial agents with broad spectrum activity against bacteria and fungi, coverage for Q-fever, i.e. chloramphenicol or tetracyclines, was not included.
authors.affiliation: Dept. of Medical Microbiology, University Hospital Nijmegen, The Netherlands.
authors.forename: J F
authors.initials: JF
authors.lastname: Meis
authors.forename: C R
authors.initials: CR
authors.lastname: Weemaes
authors.forename: A M
authors.initials: AM
authors.lastname: Horrevorts
authors.forename: S J
authors.initials: SJ
authors.lastname: Aerdts
authors.forename: P J
authors.initials: PJ
authors.lastname: Westenend
authors.forename: J M
authors.initials: JM
authors.lastname: Galama
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D001831:Body Temperature; D002648:Child; D003168:Complement Fixation Tests; D005455:Fluorescent Antibody Technique; D006105:Granulomatous Disease, Chronic / Q000150:complications*; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology; D008297:Male; D011022:Pneumonia, Rickettsial / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D011778:Q Fever / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D007075:Immunoglobulin M