title: Spontaneous splenic rupture complicating acute Q fever.
abstract: Q fever is usually a self-limited febrile illness that involves the lungs and the liver. Acute complications are rare. We present the case of a 30-yr-old patient with spontaneous splenic rupture during the course of acute Q fever infection. He was admitted to the hospital with high temperature and the radiological signs of an atypical pneumonia. Forty-eight hours after admission, he developed shock. Because of free intraabdominal liquid, a laparatomy was performed that revealed a tear in the enlarged spleen. A splenectomy was performed. The diagnosis of Q fever was established by a significant titer increase in complement fixation test and IgM-ELISA. Serological investigations into the patient's surroundings revealed evidence of Q fever infection in 10 additional persons. Q fever should be taken into account as a possible differential diagnosis in patients with unexplained febrile illness and symptoms of pneumonia. The acute course of Q fever infection can be complicated by splenic rupture. The diagnosis of an acute infection with Coxiella burnetii often requires serologic testing of a second serum sample obtained at least 10 days after the onset of symptoms. Q fever should be ruled out in cases of unexplained splenic rupture particularly in Q fever endemic areas.
authors.affiliation: Department of Medicine III, University of Tübingen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Baumbach
authors.forename: B
authors.initials: B
authors.lastname: Brehm
authors.forename: W
authors.initials: W
authors.lastname: Sauer
authors.forename: G
authors.initials: G
authors.lastname: Döller
authors.forename: H M
authors.initials: HM
authors.lastname: Hoffmeister
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D011778:Q Fever / Q000150:complications*; D012422:Rupture, Spontaneous; D013161:Splenic Rupture / Q000209:etiology*