title: Chronic Q Fever in a renal transplant recipient: a case report.
abstract: Q fever is a zoonosis caused by Coxiella burnetii that presents with a wide spectrum of acute and chronic manifestations. Progression to chronic Q fever is frequently associated with valve and vascular prosthesis, aneurisms, pregnancy, immunosuppression, and advanced chronic kidney disease. We present a case of a kidney transplant recipient with persistent fever of unknown origin, negative blood cultures, anemia, and increased erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Q fever serological tests were suggestive of chronic Q fever and the patient was diagnosed with probable chronic Q fever according to the Dutch Fever Consensus Group Guidelines. Initiation of doxycycline 200 mg/d and hydroxychloroquine 600 mg/d resulted in clinical remission. Chronic Q fever is a high-morbidity and -mortality disease if untreated and special attention has to be given to high-risk patients, such as kidney transplant recipients.
authors.affiliation: Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal. Electronic address: iolandagodinho@gmail.com.
authors.forename: I
authors.initials: I
authors.lastname: Godinho
authors.affiliation: Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
authors.forename: E L
authors.initials: EL
authors.lastname: Nogueira
authors.affiliation: Infectious Diseases Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
authors.forename: C M
authors.initials: CM
authors.lastname: Santos
authors.affiliation: Infectious Diseases Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
authors.forename: S E
authors.initials: SE
authors.lastname: Paulo
authors.affiliation: Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Fortes
authors.affiliation: Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
authors.forename: J O
authors.initials: JO
authors.lastname: Guerra
authors.affiliation: Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Gomes da Costa
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000032:analysis; D016997:Coxiella burnetii / Q000276:immunology*; D004318:Doxycycline / Q000627:therapeutic use*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011778:Q Fever / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D012698:Serologic Tests
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D004318:Doxycycline