Case report
Chronic Q fever as a cause of vertebral osteomyelitis and discitis
Ivan Puljiz
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Zoran Vranjican
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Neven Papić
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Martina Salaj
; KBC "Sr. Milosrdnice", Zagreb, Hrvatska
Oktavija Đaković Rode
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Abstract
We describe a case of chronic Q fever that presented as vertebral osteomyelitis and discitis (VOD). A 74-year-old male patient was hospitalized due to back pain that started three months before. Magnetic resonance imaging (MRI) revealed VOD of the L1-L2 vertebral segment. Initial antimicrobial treatment consisted of ciprofloxacin and rifampicin. Subsequent blood cultures were negative. Enzyme-linked immunosorbent assay revealed high antibody titers to Coxiella burnetii that was indicative of chronic Q fever. During hospitalization the patient was treated with combined antimicrobial therapy (clindamycin, ciprofloxacin, doxycycline and hydroxychloroquine) for six weeks. After discharge from the University Hospital for Infectious Diseases in Zagreb, doxycycline and hydroxychloroquine were continued. After four months of treatment, control MRI of the lumbosacral spine showed significant improvement, laboratory markers of inflammation normalized and the patient clinically recovered.
Keywords
Vertebral osteomyelitis; discitis; Coxiella burnetii; serology
Hrčak ID:
133454
URI
Publication date:
31.3.2014.
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