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CASE REPORT article

Front. Med.

Sec. Infectious Diseases: Pathogenesis and Therapy

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1626115

This article is part of the Research TopicDrug Development for Respiratory Infectious Diseases and Related Complications in Other SystemsView all 3 articles

Omadacycline in the Treatment of Severe Q Fever Pneumonia During an Influenza Epidemic: A Case Report with Literature Review

Provisionally accepted
Chuanhua  NieChuanhua NieYuan  ZhuYuan ZhuHuajuan  ZhouHuajuan ZhouXinmin  Xinmin ZhuXinmin Xinmin ZhuShaohua  HuShaohua HuXiaoli  ZhaoXiaoli ZhaoXiaohua  ZhongXiaohua ZhongFengfei  QianFengfei QianMiao  YuMiao YuQiuting  JiangQiuting Jiang*
  • Hangzhou linping hospital of interated traditional Chinese and Western medicine, Hangzhou, China

The final, formatted version of the article will be published soon.

Q fever, caused by Coxiella burnetii (Q fever rickettsiae), is a zoonotic disease with a natural reservoir and has been reported in many countries and regions. Its clinical presentation is nonspecific and easily confused with other infectious or non-infectious diseases.Conventional diagnostic methods, such as respiratory specimen culture, often fail to yield conclusive results, increasing the risk of misdiagnosis. This case involves a 78-year-old male patient from Zhejiang Province, China, who presented with fever as the primary complaint and developed severe pneumonia. The diagnosis of H1N1 influenza co-infection with Coxiella burnetii was confirmed by bronchoalveolar lavage fluid targeted high-throughput sequencing (tNGS). Following antiviral treatment with Maviroc and antibiotic therapy with omadacycline tosilate (a novel tetracycline-class drug) for Coxiella burnetii infection, the patient's clinical symptoms improved, biochemical markers normalized, and pulmonary imaging showed resolution. This case highlights the potential of tNGS to improve the detection rate of mixed infections in cases of severe pneumonia of unknown etiology. The novel tetracycline drug, such as omadacycline, has demonstrated efficacy against Q fever rickettsial pneumonia, offering a new perspective for clinical diagnosis and treatment.

Keywords: Q Fever, influenza, targeted high-throughput sequencing (tNGS), omadacycline, case

Received: 10 May 2025; Accepted: 29 Jul 2025.

Copyright: © 2025 Nie, Zhu, Zhou, Zhu, Hu, Zhao, Zhong, Qian, Yu and Jiang. 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: Qiuting Jiang, Hangzhou linping hospital of interated traditional Chinese and Western medicine, Hangzhou, China

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