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CASE REPORT article

Front. Med.

Sec. Infectious Diseases: Pathogenesis and Therapy

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1636778

Case Report: Coxiella burnetii Vertebral Osteomyelitis in a Pigeon Breeder: mNGS Diagnosis of Chronic Q Fever

Provisionally accepted
Minghui SongMinghui Song1Yumei GuoYumei Guo2Jiahao HaoJiahao Hao1Cuiying ZhengCuiying Zheng1Huifen ZuoHuifen Zuo3Chenfeng ZhangChenfeng Zhang1Zhongjun FengZhongjun Feng1Hong ZhangHong Zhang2Zhenjun ZhaoZhenjun Zhao3Weili GaoWeili Gao2*Lijie ZhangLijie Zhang1*
  • 1Third Hospital of Hebei Medical University, Shijiazhuang, China
  • 2Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang, China
  • 3Hebei Yiling Hospital, Shijiazhuang, China

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Background: Isolated vertebral osteomyelitis represents an uncommon manifestation of chronic Q fever, posing significant diagnostic challenges. We report a case of Coxiella burnetii-induced spondylodiscitis confirmed via metagenomic next-generation sequencing (mNGS). Case Report: A 52-year-old male with occupational avian exposure (pigeon breeder) presented with chronic low back pain persisting for over one year, refractory to serial epidural corticosteroid injections. Lumbar MRI demonstrated multifocal osteomyelitis (L3-L5) with associated intraspinal abscess. mNGS analysis of aspirate identified C. burnetii. Targeted dual antimicrobial therapy (vancomycin/doxycycline) induced progressive clinical resolution. Conclusion: C. burnetii, the etiological agent of Q fever, exhibits global distribution and poses significant diagnostic challenges. Its clinical manifestations are frequently nonspecific, typically afebrile, and diagnosis is commonly delayed by months to years post-symptom onset. mNGS offers critical diagnostic utility for early identification and therapeutic intervention in rare spinal infections, thereby mitigating complication risks.

Keywords: Coxiella burnetii, zoonosis, Spinal infection, metagenomicnext-generation sequencing, Chronic Q fever

Received: 02 Jun 2025; Accepted: 18 Aug 2025.

Copyright: © 2025 Song, Guo, Hao, Zheng, Zuo, Zhang, Feng, Zhang, Zhao, Gao and Zhang. 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:
Weili Gao, Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang, China
Lijie Zhang, Third Hospital of Hebei Medical University, Shijiazhuang, China

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material