title: [Q fever: bone marrow characteristic granuloma].
abstract: Q fever is a worldwise zoonosis, caused by an obligate intracellular bacterium, Coxiella burnetii. In humans, acute disease, when symptomatic, can manifest by a flu-like illness, pneumonia or hepatitis. Patients with predisposing conditions can evolve with chronic disease, which major clinical presentation is endocarditis with negative routine blood cultures. Histological studies of Q fever based on infected organs biopsies (liver and bone marrow) have demonstrated a distinctive type of granuloma, typically appearing as a "doughnut" granuloma, characterized by a central clean space surrounded by inflammatory cells and rimmed with an eosinophilic fibrinoid material. We describe a 37-year-old man, admitted to hospital for persistent fever. Bone marrow biopsy showed the characteristic "doughnut" granuloma, suggesting a Q fever. Diagnosis was then confirmed by serological tests for C. burnetii.
authors.affiliation: Service anatomie et cytologie pathologique, hôpital Gui-De-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France. vszmed@hotmail.fr
authors.forename: Vanessa
authors.initials: V
authors.lastname: Szablewski
authors.forename: Valérie
authors.initials: V
authors.lastname: Costes
authors.forename: Thérèse
authors.initials: T
authors.lastname: Rousset
authors.forename: Emile
authors.initials: E
authors.lastname: Mania
authors.forename: Nasreddine
authors.initials: N
authors.lastname: El Aoufi
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000907:Antibodies, Bacterial / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001855:Bone Marrow Diseases / Q000209:etiology* / Q000382:microbiology; D001856:Bone Marrow Examination; D016997:Coxiella burnetii / Q000276:immunology / Q000302:isolation & purification; D005335:Fever of Unknown Origin / Q000175:diagnosis* / Q000209:etiology; D006099:Granuloma / Q000209:etiology* / Q000382:microbiology; D006644:Histiocytes / Q000648:ultrastructure; D006801:Humans; D008264:Macrophages / Q000382:microbiology; D008297:Male; D011778:Q Fever / Q000150:complications / Q000175:diagnosis*; D015431:Weight Loss
chemical_list: D000907:Antibodies, Bacterial; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase