Abstract
Immunologic phenomena can complicate chronic infections with Coxiella burnetii (Q fever), including immune complex deposition causing vasculitis, neuropathy, and glomerulonephritis. We describe the case of a man with Q fever endocarditis, mixed cryoglobulinemia, and life-threatening vasculitis driven by immune complex deposition who was successfully treated with B cell depleting therapy (rituximab).
Highlights
A 71-year-old male was admitted for evaluation of night sweats, weight loss, and a vasculitic appearing rash
We report the resolution of persistent vasculitis and multiorgan sequelae resulting from mixed cryoglobulinemia with Q fever endocarditis following B cell–depletion therapy
Chronic Q fever can manifest with nonspecific constitutional symptoms, such as fever, drenching night sweats, and weight loss
Summary
A 71-year-old male was admitted for evaluation of night sweats, weight loss, and a vasculitic appearing rash. The possibility of embolic disease as the cause of his ischemic colitis was entertained, but given his clinical picture we postulated that his rash, neuropathy, and ischemic colitis resulted from immune complex deposition in the setting of a mixed cryoglobulinemia with Q fever endocarditis.
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