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Q fever osteoarticular infection: four new cases and a review of the literature

  • C. Landais
  • F. Fenollar
  • A. Constantin
  • C. Cazorla
  • C. Guilyardi
  • H. Lepidi
  • A. Stein
  • J. M. Rolain
  • D. Raoult
Article

Abstract

Q fever is a worldwide-occurring zoonosis caused by Coxiella burnetii. Better knowledge of the disease and of evolving diagnostics can enable recognition of unusual manifestations. Reported here are four cases of Q fever osteoarticular infections in adults: two cases of Q fever tenosynovitis, which represent the first two reports of this infection, and two cases of Q fever spondylodiscitis complicated by paravertebral abscess. In addition, the literature is reviewed on the 15 previously reported cases of Q fever osteoarticular infection, six of which were vertebral infections. Osteomyelitis is the usual manifestation Q fever osteoarticular infection. Because its onset is frequently insidious, diagnosis is usually delayed. The main differential diagnosis is mycobacterial infection, based on the histological granulomatous presentation of lesions. Whereas serology is the reference diagnostic method for Q fever, detection of C. burnetii in tissue specimens by PCR and cell culture provides useful additional evidence of infection. Culture-negative osteoarticular samples with granulomatous presentation upon histological examination should raise suspicion of Q fever.

Keywords

Osteomyelitis Doxycycline Carpal Tunnel Syndrome Hydroxychloroquine Flexor Tendon 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

We thank Dr. Sally Cutler for reviewing the manuscript.

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • C. Landais
    • 1
  • F. Fenollar
    • 1
  • A. Constantin
    • 2
  • C. Cazorla
    • 3
  • C. Guilyardi
    • 4
  • H. Lepidi
    • 1
  • A. Stein
    • 1
  • J. M. Rolain
    • 1
  • D. Raoult
    • 1
  1. 1.Unité des Rickettsies, IFR 48, CNRS UMR 6020, Faculté de MédecineUniversité de la MéditerranéeMarseille Cedex 5France
  2. 2.Service de RhumatologieHôpital RangueilToulouseFrance
  3. 3.Service des Maladies InfectieusesHôpital BellevueSaint EtienneFrance
  4. 4.Service de RhumatologieHôpital CaremeauNîmesFrance

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