title: [A 42-year-old farmer with nonspecific leucocytosis and elevated transaminases. Acute septic reaction in Coxiella burnetii infection].
abstract: We report about a 42-year-old farmer with leucocytosis, elevation of transaminases and liver cirrhosis as an underlying condition. The diagnosis of Q fever hepatitis was made through liver biopsy and serology. Under therapy with doxycycline, transaminases initially increased again; after switching to ciprofloxacin, the patient could be discharged 3 weeks after admission. Q fever is caused by Coxiella burnetii. The most frequent acute manifestation is a self-limiting flu-like illness. Chronic Q fever mostly presents as endocarditis. The diagnosis is made through histology ("doughnut" granulomas), PCR, serology (acute: anti-phase II antibodies, chronic: anti-phase I antibodies) and culture. Standard therapy is doxycycline.
authors.affiliation: Klinik und Poliklinik für Innere Medizin I, Klinikum der Universität Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany. ursula.hempel@klinik.uni-r.de
authors.forename: U
authors.initials: U
authors.lastname: Hempel
authors.forename: A
authors.initials: A
authors.lastname: Schäffler
authors.forename: B
authors.initials: B
authors.lastname: Salzberger
authors.forename: P
authors.initials: P
authors.lastname: Rümmele
authors.forename: J
authors.initials: J
authors.lastname: Schölmerich
mesh_terms: D000328:Adult; D000382:Agricultural Workers' Diseases / Q000175:diagnosis* / Q000473:pathology; D000822:Animal Husbandry; D000818:Animals; D001706:Biopsy; D016997:Coxiella burnetii; D003937:Diagnosis, Differential; D006801:Humans; D007964:Leukocytosis / Q000209:etiology* / Q000473:pathology; D008099:Liver / Q000473:pathology; D008104:Liver Cirrhosis, Alcoholic / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D011778:Q Fever / Q000175:diagnosis* / Q000473:pathology; D012756:Sheep; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D000637:Transaminases / Q000097:blood*
chemical_list: D000637:Transaminases