Pulmonary inflammatory pseudotumor due to Coxiella burnetii. Case report and literature review.
A 58-year-old man was admitted because of respiratory failure, episodic fever with chilling, cough, malaise, fatigue, myalgia and weight loss lasting for at least one month. Chest x-rays and CT scan of the chest showed bilateral pulmonary consolidations in upper lobes, the left lower lobe, and mediastinal lymphadenopathy. Bronchoscopy with cytology was unremarkable. A needle CT-guided lung biopsy documented an inflammatory pseudotumor, lymphoplasmacytic type. Serology showed high titer antibodies to phase II Coxiella burnetii infection. Therapy with doxycycline and hydroxychloroquine for three months led to a complete resolution of symptoms and radiological findings, and a marked decrease in titers to Q fever.
Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. Electronic address: pmaria_francesca@hotmail.com.
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Polo
Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy.
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Mastrandrea
Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy.
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Santoru
Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy.
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Arcadu
Experimental Zooprophylactic Institute of Sardinia, Sassari, Italy.
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Masala
Department of Biomedical Sciences, Institute of Pathology, University of Sassari, Sassari, Italy.
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Marras
Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy.
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Bagella
Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy.
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Sechi
Department of Biomedical Sciences, Institute of Pathology, University of Sassari, Sassari, Italy.
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Tanda
Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy.
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Pirina
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood / Q000276:immunology; D016997:Coxiella burnetii / Q000276:immunology / Q000472:pathogenicity*; D004318:Doxycycline / Q000627:therapeutic use; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016726:Plasma Cell Granuloma, Pulmonary / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology; D011778:Q Fever / Q000188:drug therapy / Q000382:microbiology; D011859:Radiography
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D006886:Hydroxychloroquine; D004318:Doxycycline
Coxiella burnetii; Infection; Pulmonary pseudotumor