Rapidly fatal Q-fever pneumonia in a patient with chronic granulomatous disease.
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.
Meis
J F
JF
Dept. of Medical Microbiology, University Hospital Nijmegen, The Netherlands.
Weemaes
C R
CR
Horrevorts
A M
AM
Aerdts
S J
SJ
Westenend
P J
PJ
Galama
J M
JM
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
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D007075:Immunoglobulin M