Abstract
Coxiella burnetii is the causative agent of Q fever. Q fever is a worldwide zoonosis that is responsible for various clinical manifestations. However, in Greece hepatitis due to Coxiella is rarely encountered. A case of Q fever associated with hepatitis is reported here. Diagnosis was made by specific serological investigation (enzyme-linked immunosorbent and indirect immunofluorescene assays) for Coxiella burnetii.
Highlights
Q fever is caused by the obligate intracellular bacterium Coxiella burnetii
The clinical manifestations of Q fever may be so variable that the disease is often diagnosed only if it has been systematically considered
Q fever hepatitis has been rarely reported in Greece [7]
Summary
Q fever is caused by the obligate intracellular bacterium Coxiella burnetii. The primary reservoirs of infection are farm animals such as cattle, goats and sheep. The infection has two forms, acute and chronic, whereas half of the patients remain asymptomatic. Fever persisted and the patient developed fatigue, chills, anorexia, headaches, myalgia and skin rash (pink macular lesions of the trunk). When he revisited the emergency department, he was hospitalized for further diagnostic evaluation. A convalescent-phase serum sample was obtained 3 weeks later, confirming the initial diagnosis. It was tested by ELISA [IgG I (1,9x cutoff), IgG II 149 IU/ml)] and IFA [IgG I 1:256, IgG II 1:1024]. During a follow-up visit 3 months after hospitalization, the patient was clinically asymptomatic and had normal hepatic enzymes
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