title: Diffuse abdominal uptake mimicking peritonitis in gallium inflammatory scan: an unusual feature of acute Q fever.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Kaohsiung Medical University and Kaohsiung Medical University Hsaio-Kang Hospital, Kaohsiung, Taiwan.
authors.forename: Ko
authors.initials: K
authors.lastname: Chang
authors.forename: Wen-Chien
authors.initials: WC
authors.lastname: Ko
authors.forename: Bi-Fang
authors.initials: BF
authors.lastname: Li
authors.forename: Ping-Yen
authors.initials: PY
authors.lastname: Liu
authors.forename: Nan-Tsing
authors.initials: NT
authors.lastname: Chiu
mesh_terms: 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
chemical_list: D005710:Gallium Radioisotopes