Diffuse abdominal uptake mimicking peritonitis in gallium inflammatory scan: an unusual feature of acute Q fever.
The clinical features in patients with acute Q fever are variable. We present a patient with fever, abdominal distension, pericardial effusion, and diffuse gallium uptake in the abdominal cavity, mimicking peritonitis or peritoneum carcinomatosis. Serologic surveys revealed acute infection by Coxiella burnetii. The patient responded poorly to doxycycline and improved with oral levofloxacin. During the afebrile period, gallium inflammatory scan showed resolution of previous diffuse uptake in the abdomen, and cardiac echo resolution of pericardial effusion, which was suggestive of peritoneal inflammation related to acute C. burnetii infection. Therefore, clinicians in Taiwan should be alert to the possibility of acute Q fever in patients with fever of unknown cause, especially with clinical evidence of peritoneal and/or pericardial inflammation.
Chang
Ko
K
Department of Internal Medicine, Kaohsiung Medical University and Kaohsiung Medical University Hsaio-Kang Hospital, Kaohsiung, Taiwan.
Ko
Wen-Chien
WC
Li
Bi-Fang
BF
Liu
Ping-Yen
PY
Chiu
Nan-Tsing
NT
D034841:Abdominal Cavity / Q000000981:diagnostic imaging*; D000208:Acute Disease; D005710:Gallium Radioisotopes; D006801:Humans; D008099:Liver / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010493:Pericarditis / Q000000981:diagnostic imaging; D010538:Peritonitis / Q000000981:diagnostic imaging*; D011778:Q Fever / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D011877:Radionuclide Imaging
D005710:Gallium Radioisotopes