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Chronic Q Fever in a renal transplant recipient: a case report

I Godinho1, E L Nogueira1, C M Santos2

  • 1Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.

Transplantation Proceedings
|June 4, 2015
PubMed

Insights

Q fever, a Coxiella burnetii infection, can cause severe chronic illness. Early diagnosis and treatment in kidney transplant recipients are crucial for managing this high-morbidity disease.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Transplantation

Background:

  • Q fever is a zoonotic infection caused by Coxiella burnetii, presenting with diverse acute and chronic symptoms.
  • Chronic Q fever is linked to specific risk factors including vascular prosthesis, pregnancy, immunosuppression, and advanced chronic kidney disease.

Observation:

  • A kidney transplant recipient experienced prolonged fever, anemia, and elevated inflammatory markers (ESR, CRP) with negative blood cultures.
  • Serological tests indicated chronic Q fever, leading to a probable diagnosis based on Dutch Fever Consensus Group Guidelines.

Findings:

  • The patient was diagnosed with probable chronic Q fever.
  • Treatment with doxycycline and hydroxychloroquine achieved clinical remission.

Implications:

  • This case highlights the importance of considering chronic Q fever in immunocompromised patients, particularly kidney transplant recipients, presenting with unexplained fever.
  • Prompt diagnosis and treatment are essential to prevent severe morbidity and mortality associated with chronic Q fever.

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