title: Chronic Q-Fever (Coxiella burnetii) Causing Abdominal Aortic Aneurysm and Lumbar Osteomyelitis: A Case Report.
abstract: Coxiella burnetii is a rare cause of chronic infection that most frequently presents as endocarditis. We report a case of C burnetii causing an infected abdominal aortic aneurysm with contiguous lumbar osteomyelitis resulting in spinal cord compromise. The diagnosis was established by serologic studies consistent with chronic Q-fever (ratio of C burnetii immunoglobulin [Ig]G phase II titer to IgG phase I titer <1) and was confirmed by positive C burnetii polymerase chain reaction of vertebral tissue in addition to pathology of vertebral bone showing intracellular Gram-negative coccobacillary bacteria. The patient clinically improved after surgical decompression and prolonged treatment with doxycycline and hydroxychloroquine.
authors.affiliation: Divisions of Infectious Diseases.
authors.forename: P Alexander
authors.initials: PA
authors.lastname: Leahey
authors.affiliation: Pathology.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Tahan
authors.affiliation: Neurosurgery , Beth Israel Deaconess Medical Center, Harvard Medical School , Boston, Massachusetts.
authors.forename: Ekkehard M
authors.initials: EM
authors.lastname: Kasper
authors.affiliation: Divisions of Infectious Diseases.
authors.forename: Mary
authors.initials: M
authors.lastname: Albrecht
keywords: Coxiella burnetii; Q-fever; abdominal aortic aneurysm; chronic Q-fever; osteomyelitis