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A Case of Pediatric Q Fever Osteomyelitis Managed Without Antibiotics
Ameneh Khatami1, Rebecca T Sparks2, Ben J Marais3
1Department of Microbiology and Infectious Diseases, The Children's Hospital at Westmead, Sydney, Australia; and University of Sydney, School of Medicine, Sydney, Australia ameneh.khatami@health.nsw.gov.au ameneh.khatami@gmail.com.
Abstract:
Q fever osteomyelitis, caused by infection with Coxiella burnetti, is rare but should be included in the differential diagnosis of children with culture-negative osteomyelitis, particularly if there is a history of contact with farm animals, and/or granulomatous change on histologic examination of a bone biopsy specimen. We describe a case of Q fever osteomyelitis in a 6-year-old boy in which a decision was made not to treat the patient with combination antimicrobial agents, balancing possible risks of recurrence against potential side effects of prolonged antibiotic treatment. The patient had undergone surgical debridement of a single lesion and was completely asymptomatic after recovery from surgery. This case suggests that a conservative approach of watchful waiting in an asymptomatic patient with chronic Q fever osteomyelitis may be warranted in select cases when close follow-up is possible.
Insights
Q fever osteomyelitis, a rare Coxiella burnetti infection, should be considered in children with unexplained bone infections. A conservative approach may be suitable for asymptomatic cases with close monitoring.
Area of Science:
- Pediatric Infectious Diseases
- Bone Infections
- Microbiology
Background:
- Q fever osteomyelitis, caused by Coxiella burnetti, is a rare condition.
- It should be considered in the differential diagnosis of culture-negative osteomyelitis in children.
- Risk factors include contact with farm animals and granulomatous changes on bone biopsy.
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