[Bone marrow granulomatosis in Q-fever].
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.
Rexroth
G
G
Medizinische Klinik, Krankenhauses Nordwest der Stiftung Hospital zum Heiligen Geist, Frankfurt/M. Rexrothmed@aol.com
Rösch
W
W
Altmannsberger
M
M
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
D000907:Antibodies, Bacterial