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Sternoclavicular joint infection caused by Coxiella burnetii: a case report
BACKGROUND: Few cases of Q fever osteoarticular infection have been reported, with chronic osteomyelitis as the most common manifestation of Q fever osteoarticular infection. Here we present the case of a sternoclavicular joint infection caused by Coxiella burnetii and localized by positron emission...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888605/ https://www.ncbi.nlm.nih.gov/pubmed/27246557 http://dx.doi.org/10.1186/s13256-016-0948-x |
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author | Angelakis, Emmanouil Thiberville, Simon-Djamel Million, Matthieu Raoult, Didier |
author_facet | Angelakis, Emmanouil Thiberville, Simon-Djamel Million, Matthieu Raoult, Didier |
author_sort | Angelakis, Emmanouil |
collection | PubMed |
description | BACKGROUND: Few cases of Q fever osteoarticular infection have been reported, with chronic osteomyelitis as the most common manifestation of Q fever osteoarticular infection. Here we present the case of a sternoclavicular joint infection caused by Coxiella burnetii and localized by positron emission tomography scanning. CASE PRESENTATION: A 67-year-old French man from south France was hospitalized for fever and confusion. An examination revealed subclavicular and axillary lymph node enlargement. Computed tomography scanning and transesophageal echocardiogram were normal, and magnetic resonance imaging scanning did not reveal signs of infection. An immunofluorescence assay of an acute serum sample was positive for C. burnetii and he was treated with 200 mg doxycycline for 21 days. An immunofluorescence assay of convalescent serum sampled after 2 months revealed very high C. burnetii antibody titers. To localize the site of the infection, we performed positron emission tomography scanning, which revealed intense fluorodeoxyglucose uptake in his right sternoclavicular joint; treatment with 200 mg oral doxycycline daily and 200 mg oral hydroxychloroquine three times daily for 18 months was initiated. CONCLUSIONS: Q fever articular infections may be undiagnosed, and we strongly urge the use of positron emission tomography scanning in patients with high C. burnetii antibody titers to localize the site of C. burnetii infection. |
format | Online Article Text |
id | pubmed-4888605 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-48886052016-06-02 Sternoclavicular joint infection caused by Coxiella burnetii: a case report Angelakis, Emmanouil Thiberville, Simon-Djamel Million, Matthieu Raoult, Didier J Med Case Rep Case Report BACKGROUND: Few cases of Q fever osteoarticular infection have been reported, with chronic osteomyelitis as the most common manifestation of Q fever osteoarticular infection. Here we present the case of a sternoclavicular joint infection caused by Coxiella burnetii and localized by positron emission tomography scanning. CASE PRESENTATION: A 67-year-old French man from south France was hospitalized for fever and confusion. An examination revealed subclavicular and axillary lymph node enlargement. Computed tomography scanning and transesophageal echocardiogram were normal, and magnetic resonance imaging scanning did not reveal signs of infection. An immunofluorescence assay of an acute serum sample was positive for C. burnetii and he was treated with 200 mg doxycycline for 21 days. An immunofluorescence assay of convalescent serum sampled after 2 months revealed very high C. burnetii antibody titers. To localize the site of the infection, we performed positron emission tomography scanning, which revealed intense fluorodeoxyglucose uptake in his right sternoclavicular joint; treatment with 200 mg oral doxycycline daily and 200 mg oral hydroxychloroquine three times daily for 18 months was initiated. CONCLUSIONS: Q fever articular infections may be undiagnosed, and we strongly urge the use of positron emission tomography scanning in patients with high C. burnetii antibody titers to localize the site of C. burnetii infection. BioMed Central 2016-05-31 /pmc/articles/PMC4888605/ /pubmed/27246557 http://dx.doi.org/10.1186/s13256-016-0948-x Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Angelakis, Emmanouil Thiberville, Simon-Djamel Million, Matthieu Raoult, Didier Sternoclavicular joint infection caused by Coxiella burnetii: a case report |
title | Sternoclavicular joint infection caused by Coxiella burnetii: a case report |
title_full | Sternoclavicular joint infection caused by Coxiella burnetii: a case report |
title_fullStr | Sternoclavicular joint infection caused by Coxiella burnetii: a case report |
title_full_unstemmed | Sternoclavicular joint infection caused by Coxiella burnetii: a case report |
title_short | Sternoclavicular joint infection caused by Coxiella burnetii: a case report |
title_sort | sternoclavicular joint infection caused by coxiella burnetii: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888605/ https://www.ncbi.nlm.nih.gov/pubmed/27246557 http://dx.doi.org/10.1186/s13256-016-0948-x |
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