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[Acute meningoencephalitis caused by Coxiella burnetii with periodic EEG complexes]
V Mateos1, J Salas Puig, P Leiva
1Servicio de Neurología, Hospital General de Asturias, Oviedo.
Abstract:
Q fever is a zoonosis found worldwide and is produced by Coxiella burnetii. It may be acute or chronic with neurological manifestations being infrequent. Several cases of acute encephalitis or meningoencephalitis have been described, generally with an evolution towards cure regardless of the use of selective antibiotic treatment. Recently the authors had the opportunity to study a 33 year old male presenting acute meningoencephalitis in which the clinical manifestations, CSF findings (increase in cellularity with lymphocytic predominance and excess proteins ) and neurophysiological findings (appearance of periodic bilateral complexes in the EEG) suggested the diagnosis of herpetic meningoencephalitis. Treatment with acyclovir was initiated. However, serologic studies demonstrated, a posteriori, that the germ responsible had been Coxiella burnetii. The patient evolved satisfactorily with no specific treatment and the EEG anomalies disappeared within a few days. The authors insist on the need to include Q Fever in the diagnostic differential of acute meningoencephalitis and emphasize the possibility that germs of a non viral nature may produce periodic EEG complexes in all that similar to those found in herpetic encephalitis.
Insights
Q fever, caused by Coxiella burnetii, can present as acute meningoencephalitis. This case highlights the need to consider Q fever in diagnosing meningoencephalitis, even with EEG findings mimicking herpes encephalitis.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiology
Background:
- Q fever is a worldwide zoonosis caused by Coxiella burnetii, with neurological manifestations being rare.
- Acute meningoencephalitis is an uncommon presentation of Q fever, often resolving spontaneously.
Observation:
- A 33-year-old male presented with acute meningoencephalitis, exhibiting clinical, CSF, and EEG findings suggestive of herpetic meningoencephalitis.
- Initial treatment included acyclovir, but subsequent serologic studies confirmed Coxiella burnetii as the causative agent.
Findings:
- The patient recovered well without specific antibiotic treatment for Q fever.
- Electroencephalogram (EEG) abnormalities resolved within days, demonstrating that non-viral pathogens can cause periodic complexes similar to herpetic encephalitis.
Implications:
- Q fever should be included in the differential diagnosis of acute meningoencephalitis.
- Periodic EEG complexes, typically associated with viral encephalitis, can be indicative of non-viral infections like Q fever.