title: Histological characteristics of the abdominal aortic wall in patients with vascular chronic Q fever.
abstract: The aim of this study was to describe specific histological findings of the Coxiella burnetii-infected aneurysmal abdominal aortic wall. Tissue samples of the aneurysmal abdominal aortic wall from seven patients with chronic Q fever and 15 patients without evidence of Q fever infection were analysed and compared. Chronic Q fever was diagnosed using serology and tissue PCR analysis. Histological sections were stained using haematoxylin and eosin staining, Elastica van Gieson staining and immunohistochemical staining for macrophages (CD68), T lymphocytes (CD3), T lymphocyte subsets (CD4 and CD8) and B lymphocytes (CD20). Samples were scored by one pathologist, blinded for Q fever status, using a standard score form. Seven tissue samples from patients with chronic Q fever and 15 tissue samples from patients without Q fever were collected. Four of seven chronic Q fever samples showed a necrotizing granulomatous response of the vascular wall, which was characterized by necrotic core of the arteriosclerotic plaque (P = 0.005) and a presence of high numbers of macrophages in the adventitia (P = 0.007) distributed in typical palisading formation (P = 0.005) and surrounded by the presence of high numbers of T lymphocytes located diffusely in media and adventitia. Necrotizing granulomas are a histological finding in the C. burnetii-infected aneurysmal abdominal aortic wall. Chronic Q fever should be included in the list of infectious diseases with necrotizing granulomatous response, such as tuberculosis, cat scratch disease and syphilis.
authors: Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.
authors: Julia C J P
authors: JC
authors: Hagenaars
authors: Olivier H J
authors: OH
authors: Koning
authors: Ronald F F
authors: RF
authors: van den Haak
authors: Bart A N
authors: BA
authors: Verhoeven
authors: Nicole H M
authors: NH
authors: Renders
authors: Mirjam H A
authors: MH
authors: Hermans
authors: Peter C
authors: PC
authors: Wever
authors: Robert Jan
authors: RJ
authors: van Suylen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000382:microbiology* / Q000473:pathology*; D017544:Aortic Aneurysm, Abdominal / Q000382:microbiology* / Q000473:pathology*; D001402:B-Lymphocytes / Q000473:pathology; D016997:Coxiella burnetii / Q000302:isolation & purification; D005260:Female; D006099:Granuloma / Q000473:pathology; D006801:Humans; D008264:Macrophages / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011446:Prospective Studies; D011778:Q Fever / Q000382:microbiology* / Q000473:pathology*; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000473:pathology
keywords: aneurysm; chronic Q fever; granulomatous disease; infection; vascular disease