CASE REPORT article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1584216
An acute Q fever with vessel vasculitis: Case Report
Provisionally accepted
- 1Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
- 2Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
- 3Yuexiu District Hospital of Chinese Medicine, Guangzhou, China
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Background Q fever (QF) is a relatively rare zoonotic infectious disease, and complications such as vasculitis and endocarditis are uncommon but severe. This article reports a case of acute QF complicated by vasculitis.The patient presented with a week of recurrent fever. Upon admission, inflammatory markers and liver transaminases were elevated, and a weak positive result for Chlamydia pneumoniae Immunoglobulin M(IgM) antibodies was detected. After treatment with levofloxacin and doxycycline, the fever persisted.Blood metagenomic next-generation sequencing (mNGS) suggested Coxiella species, raising suspicion for acute QF. The antibiotics were switched to moxifloxacin, but fever continued. Autoimmune tests showed positive antinuclear antibodies, and multiple blood cultures were negative. Further positron emission tomography / computedtomography (PET/CT) revealed inflammatory changes at the bifurcation of the right internal and external carotid arteries, as well as the ascending aorta, pulmonary arteries, and descending aorta, suggesting QF complicated by vasculitis.Treatment with methylprednisolone led to gradual resolution of the fever, and rechecked autoimmune antibodies turned negative. The patient did not experience further fever after discharge.Conclusions Currently, early recognition and diagnostic techniques for QF still require further improvement. As an infectious disease, timely treatment and vaccination for QF remain key areas of focus for future healthcare professionals.
Keywords: Q Fever, vessel vasculitis, case report, NGS, PET/CT
Received: 27 Feb 2025; Accepted: 11 Jun 2025.
Copyright: © 2025 Guo, Liu, Yan, Wang, Zhong, Gao and Zhong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shijun Guo, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
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