title: [Bone marrow granulomatosis in Q-fever].
abstract: BACKGROUND
  Petersdorf and Beeson defined Fever of Unknown Origin (FUO) as an illness characterized by rectal temperature exceeding 38.3 degrees C on at least 3 occasions, evolving during at least 3 weeks, with no diagnosis reached after 1 week of in-patient investigation. A quarter of FUO cases is caused by infectious diseases, most often hidden abscesses, subacute endocarditis and tuberculosis.
  
  
  METHODS
  In a 29-year-old patient with undulating fever of 3 months duration solely the demonstration of bone marrow fibrin ring granulomas led to the diagnosis of protracted Q-fever. The diagnosis later has been proved by elevated Coxiella burnetii antibody titers.
  
  
  CONCLUSIONS
  The case report underlines the diagnostic value of bone marrow biopsy in the evaluation of fever of unknown origin.
authors.affiliation: Medizinische Klinik, Krankenhauses Nordwest der Stiftung Hospital zum Heiligen Geist, Frankfurt/M. Rexrothmed@aol.com
authors.forename: G
authors.initials: G
authors.lastname: Rexroth
authors.forename: W
authors.initials: W
authors.lastname: Rösch
authors.forename: M
authors.initials: M
authors.lastname: Altmannsberger
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology*; D016997:Coxiella burnetii / Q000276:immunology / Q000302:isolation & purification*; D003937:Diagnosis, Differential; D005335:Fever of Unknown Origin / Q000382:microbiology*; D006099:Granuloma / Q000382:microbiology; D006801:Humans; D008297:Male; D011778:Q Fever / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology
chemical_list: D000907:Antibodies, Bacterial