[Splenic abscess caused by Coxiella burnetti in the absence of endocarditis].
BACKGROUND
The most frequent clinical expression of chronic Q fever is culture-negative endocarditis. Other localizations are rare.


METHODS
We report a documented case of chronic Q fever that occurred in a 47-year-old immunocompetent man and was associated with spleen abscess, in the absence of detectable endocarditis. The spleen abscess was a complication of either a preexisting cyst or a calcified hematoma. Splenic infection with Coxiella burnetii was documented with cultures, polymerase chain reaction and immunohistochemistry. The outcome was favorable after splenectomy and a 21-month antibiotherapy.


CONCLUSIONS
Chronic Q fever may develop in the absence of endocarditis, when a preexisting vascular lesion such as aortic aneurysm exists. A splenic cyst may have played a similar role for this patient.
Cathébras
P
P
Service de médecine interne, CHU Nord, Saint-Etienne, France.
Brouqui
P
P
Philippe
P
P
Raoult
D
D
Rousset
H
H
D000038:Abscess / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D000942:Antigens, Bacterial / Q000032:analysis; D016997:Coxiella burnetii / Q000276:immunology; D003560:Cysts / Q000150:complications; D019084:Fluorescent Antibody Technique, Indirect; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011778:Q Fever / Q000150:complications*; D013156:Splenectomy; D013158:Splenic Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D000942:Antigens, Bacterial
Abcès splénique à Coxiella burnetii en l'absence d'endocardite.