title: [Hepatic granulomatosis caused by Q fever: a cause of erroneous tuberculosis diagnosis].
abstract: We present the case of a 31-year-old man hospitalized for the study of a fever syndrome. The patient developed acute respiratory failure, with anemia and hepatic affection. In the histological examination of the liver and bone marrow, the presence of granulomas suggesting a tuberculous etiology was demonstrated. Antibodies IgG anti-Coxiella burnetti were detected, using indirect immunofluorescence, at the level of 1/200, with latter seroconversion to 1/800. Therapy with doxycycline was administered (200 mg/day during 14 days). Fever subsided in 24 hours and the other clinico-biochemical disorders disappeared in the following days. After the literature review, we conclude that Q fever must be taken into account for the differential diagnosis of any granulomatous disease observed in the liver and/or bone marrow. We can confirm that any granuloma is specific of just one pathological entity. The diagnosis must be always supported by other clinical, supplementary and serological data.
authors.affiliation: Departamento de Medicina Interna, Hospital Universitario Regional Infanta Cristina, Facultad de Medicina de la UNEX Badajoz.
authors.forename: J D
authors.initials: JD
authors.lastname: Arrebola García
authors.forename: D
authors.initials: D
authors.lastname: Magro Ledesma
authors.forename: C
authors.initials: C
authors.lastname: Montero Leal
authors.forename: A
authors.initials: A
authors.lastname: Vera Tome
authors.forename: M
authors.initials: M
authors.lastname: Pérez Miranda
mesh_terms: D000208:Acute Disease; D000328:Adult; D000740:Anemia / Q000209:etiology; D001988:Bronchiolitis / Q000209:etiology; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005335:Fever of Unknown Origin / Q000209:etiology; D006099:Granuloma / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D011778:Q Fever / Q000150:complications / Q000175:diagnosis*; D012131:Respiratory Insufficiency / Q000209:etiology; D014375:Tuberculoma / Q000175:diagnosis*; D014386:Tuberculosis, Hepatic / Q000175:diagnosis*
vernacular_title: Granulomatosis hepática por fiebre Q: una causa de falso diagnóstico de tuberculosis.