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Azouzi F, Olagne L, Edouard S, Cammilleri S, Magnan PE, Fournier PE, Million M. Coxiella burnetii Femoro-Popliteal Bypass Infection: A Case Report. Microorganisms 2023; 11:2146. [PMID: 37763990 PMCID: PMC10538191 DOI: 10.3390/microorganisms11092146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/09/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Cardiovascular infections are the most severe and potentially lethal among the persistent focalized Coxiella burnetii infections. While aortic infections on aneurysms or prostheses are well-known, with specific complications (risk of fatal rupture), new non-aortic vascular infections are increasingly being described thanks to the emerging use of 18-fluorodeoxyglucose positron emission tomography (18F-FDG PET-scan). Here, we describe an infection of a femoro-popliteal bypass that would not have been diagnosed without the use of PET-scan. It is well-known that vascular prosthetic material is a site favorable for bacterial persistence, but the description of unusual anatomical sites, outside the heart or aorta, should raise the clinicians' awareness and generalize the indications for PET-scan, with careful inclusion of the upper and lower limbs (not included in PET-scan for cancer), particularly in the presence of vascular prostheses. Future studies will be needed to precisely determine their optimal management.
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Affiliation(s)
- Farah Azouzi
- Laboratoire de Microbiologie CHU Sahloul Sousse Tunisie, LR20SP06, Faculté de Médecine de Sousse Tunisie, Université de Sousse, Sousse 4003, Tunisia;
| | - Louis Olagne
- Service de Médecine Interne, Centre Hospitalier Universitaire Gabriel-Montpied, 63000 Clermont-Ferrand, France;
| | - Sophie Edouard
- UMR MEPHI, Institut Hospitalo-Universitaire Méditerranée Infection, Institut de la Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, 13005 Marseille, France;
- French Reference Center for Rickettsioses, Q Fever and Bartonelloses, Institut Hospitalo-Universitaire Méditerranée Infection, 13005 Marseille, France;
| | - Serge Cammilleri
- Service de Médecine Nucléaire Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France;
| | - Pierre-Edouard Magnan
- Service de Chirurgie Vasculaire, Hôpital Timone, Assistance Publique-Hôpitaux de Marseille, 13385 Marseille, France;
| | - Pierre-Edouard Fournier
- French Reference Center for Rickettsioses, Q Fever and Bartonelloses, Institut Hospitalo-Universitaire Méditerranée Infection, 13005 Marseille, France;
- UMR VITROME, Institut Hospitalo-Universitaire Méditerranée-Infection, Institut de la Recherche pour le Développement, Service de Santé des Armées, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, 13005 Marseille, France
| | - Matthieu Million
- UMR MEPHI, Institut Hospitalo-Universitaire Méditerranée Infection, Institut de la Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, 13005 Marseille, France;
- French Reference Center for Rickettsioses, Q Fever and Bartonelloses, Institut Hospitalo-Universitaire Méditerranée Infection, 13005 Marseille, France;
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Sivabalan P, Visvalingam R, Grey V, Blazak J, Henderson A, Norton R. Utility of positron emission tomography imaging in the diagnosis of chronic Q fever: A Systematic Review. J Med Imaging Radiat Oncol 2021; 65:694-709. [PMID: 34056851 DOI: 10.1111/1754-9485.13244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/29/2021] [Indexed: 11/28/2022]
Abstract
Chronic Q fever is a diagnostic challenge. Diagnosis relies on serology and/or the detection of DNA from blood or tissue samples. PET-CT identifies tissues with increased glucose metabolism, thus identifying foci of inflammation. Our aim was to review the existing literature on the use of PET-CT to help diagnose chronic Q fever. A literature search was conducted in PubMed and Google Scholar to ascertain publications that included the terms 'Positron Emission Tomography' and 'PET CT' in combination with subheadings 'chronic Q fever' and 'Coxiella burnetii' within the search. To broaden our search retrieval, we used the terms 'chronic Q fever' and 'PET-CT'. Published literature up to 16th April 2020 was included. 274 articles were initially identified. Post-exclusion criteria, 46 articles were included. Amongst case reports and series, the most frequent focus of infection was vascular, followed by musculoskeletal then cardiac. 79.5% of patients had a focus detected with 55.3% of these having proven infected prosthetic devices. Amongst the retrospective and prospective studies, a total of 394 positive sites of foci were identified with 186 negative cases. Some had follow-up scans (53), with 75.5% showing improvement or resolution. Average timeframe for documented radiological resolution post-initiating treatment was 8.86 months. PET-CT is a useful tool in the management of chronic Q fever. Knowledge of a precise focus enables for directed surgical management helping reduce microbial burden, preventing future complications. Radiological resolution of infection can give clinicians reassurance on whether antimicrobial therapy can be ceased earlier, potentially limiting side effects.
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Affiliation(s)
- Pirathaban Sivabalan
- Department of Infectious Diseases, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,Pathology Queensland, Townsville University Hospital, Douglas, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Rozanne Visvalingam
- Department of Radiology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Victoria Grey
- Department of Infectious Diseases, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - John Blazak
- Department of Radiology, Sunshine Coast University Hospital, Birtinya, Queensland, Australia
| | - Andrew Henderson
- Department of Infectious Diseases, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Robert Norton
- Pathology Queensland, Townsville University Hospital, Douglas, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
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