title: A Case of Pediatric Q Fever Osteomyelitis Managed Without Antibiotics.
abstract: Q fever osteomyelitis, caused by infection with Coxiella burnetti, is rare but should be included in the differential diagnosis of children with culture-negative osteomyelitis, particularly if there is a history of contact with farm animals, and/or granulomatous change on histologic examination of a bone biopsy specimen. We describe a case of Q fever osteomyelitis in a 6-year-old boy in which a decision was made not to treat the patient with combination antimicrobial agents, balancing possible risks of recurrence against potential side effects of prolonged antibiotic treatment. The patient had undergone surgical debridement of a single lesion and was completely asymptomatic after recovery from surgery. This case suggests that a conservative approach of watchful waiting in an asymptomatic patient with chronic Q fever osteomyelitis may be warranted in select cases when close follow-up is possible.
authors.affiliation: Department of Microbiology and Infectious Diseases, The Children's Hospital at Westmead, Sydney, Australia; and University of Sydney, School of Medicine, Sydney, Australia ameneh.khatami@health.nsw.gov.au ameneh.khatami@gmail.com.
authors.forename: Ameneh
authors.initials: A
authors.lastname: Khatami
authors.affiliation: University of Sydney, School of Medicine, Sydney, Australia.
authors.forename: Rebecca T
authors.initials: RT
authors.lastname: Sparks
authors.affiliation: Department of Microbiology and Infectious Diseases, The Children's Hospital at Westmead, Sydney, Australia; and University of Sydney, School of Medicine, Sydney, Australia.
authors.forename: Ben J
authors.initials: BJ
authors.lastname: Marais
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D003646:Debridement; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D011778:Q Fever / Q000175:diagnosis / Q000601:surgery*; D057832:Watchful Waiting
chemical_list: D000900:Anti-Bacterial Agents