title: [A case of miliary tuberculosis complicating acute Q fever].
abstract: A 73-year-old man was admitted with fever and abnormal liver function test. After admission, his fever persisted in spite of administrating a variety of antibiotics. He was diagnosed as acute Q fever on the basis of a high titer of IgM antibodies against phase II Coxiella burneti. His fever resolved after starting minocycline, but biliary enzymes continued to be elevated. Transbronchial lung biopsy and percutaneous liver biopsy revealed caseating granulomas and Mycobacterium tuberculosis was detected by culture. Miliary tuberculosis was diagnosed and his biliary enzymes declined after starting therapy with antituberculous drugs. This report of miliary tuberculosis complicating acute Q fever is a valuable and unprecedented case.
authors.affiliation: Department of Gastroenterology and Hepatology, Nara City Hospital.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sumida
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Kanemasa
authors.forename: Kohei
authors.initials: K
authors.lastname: Fukumoto
authors.forename: Naho
authors.initials: N
authors.lastname: Katoh
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Imamura
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Itoh
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okanoue
mesh_terms: D000208:Acute Disease; D000368:Aged; D006801:Humans; D008168:Lung / Q000473:pathology; D008297:Male; D011778:Q Fever / Q000209:etiology*; D014391:Tuberculosis, Miliary / Q000150:complications* / Q000473:pathology