The First Case of Coxiella Burnetti Infection Detected Through Bone Marrow Biopsy in Vietnam.
Clin Med Insights Pathol 2022;
15:2632010X221096397. [PMID:
35592738 PMCID:
PMC9112304 DOI:
10.1177/2632010x221096397]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 04/04/2022] [Indexed: 12/03/2022] Open
Abstract
Coxiella burnetii is an obligate intracellular bacterium that
causes the zoonotic infectious disease, Q fever. The common clinical
presentation is fever, hepatitis, and pneumonia; laboratory examination could
reveal pancytopenia, elevated liver enzymes. In bone marrow, many fibrin ring
granulomas, also known as “Doughnut” granulomas can be seen and suggest the
diagnosis of Q fever. However, these bone marrow granulomas can also be
presented in infectious diseases by other pathogens such as EBV, CMV, and HBV;
therefore, other serology or PCR—based tests are needed to confirm the diagnosis
of Q fever. We report the first case of acute Q fever in Vietnam, presented as a
fever of unknown origin with hepatitis in a 53-year-old male patient. A bone
marrow biopsy was performed and showed various fibrin ring granulomas;
therefore, Coxiella was suspected and the diagnosis was
confirmed by PCR. Some infectious diseases can cause specific changes in the
bone marrow, such as Doughnut granulomas in Q fever. These features can help
direct the diagnosis and decide earlier treatment for the patient.
Collapse