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Primary aortoduodenal fistula and Q fever: an underrecognized association?

A Mejia1, B Toursarkissian, R T Hagino

  • 1Department of Surgery, University of Texas Health Science Center at San Antonio, 78229, USA.

Annals of Vascular Surgery
|May 5, 2000
PubMed

Insights

A rare aortoduodenal fistula (ADF) caused by Coxiella burnetii (Q fever) infection in an abdominal aortic aneurysm patient is detailed. Q fever should be considered in vascular cases with animal contact and negative standard infection tests.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Public Health

Background:

  • Primary aortoduodenal fistula (ADF) is a rare but life-threatening condition.
  • Coxiella burnetii (Q fever) infection can cause various vascular complications.
  • Abdominal aortic aneurysms are associated with increased risk of fistula formation.

Observation:

  • A rare case of primary ADF secondary to Q fever infection in a patient with an abdominal aortic aneurysm is presented.
  • The patient's presentation mimicked other causes of abdominal sepsis, delaying diagnosis.
  • Literature review highlights the under-recognized vascular manifestations of Q fever.

Findings:

  • Q fever should be suspected in patients with vascular disease and a history of animal exposure, especially when routine infectious workups are inconclusive.
  • Early recognition and appropriate antibiotic therapy are crucial for managing Q fever-related vascular complications.
  • Diagnostic challenges and management strategies for primary ADF were reviewed.

Implications:

  • This case underscores the importance of considering atypical infections like Q fever in the differential diagnosis of vascular emergencies.
  • Enhanced awareness among clinicians can lead to earlier diagnosis and improved outcomes for patients with Q fever-induced vascular complications.
  • Further research into the pathogenesis and optimal management of Q fever's vascular sequelae is warranted.

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