[Hepatic granulomatosis caused by Q fever: a cause of erroneous tuberculosis diagnosis].
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.
Arrebola García
J D
JD
Departamento de Medicina Interna, Hospital Universitario Regional Infanta Cristina, Facultad de Medicina de la UNEX Badajoz.
Magro Ledesma
D
D
Montero Leal
C
C
Vera Tome
A
A
Pérez Miranda
M
M
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*
Granulomatosis hepática por fiebre Q: una causa de falso diagnóstico de tuberculosis.