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Acute Q fever hepatitis in Taiwan
1Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
Journal of Gastroenterology and Hepatology
|January 1, 1995
Summary
A chronic hepatitis B carrier presented with symptoms mimicking an acute exacerbation, but liver biopsy revealed Q fever. This treatable condition, Coxiella burnetii infection, is crucial to consider in atypical hepatitis cases.
Area of Science:
- Hepatology
- Infectious Diseases
- Microbiology
Background:
- Hepatitis B virus (HBV) infection is a significant global health concern.
- Chronic HBV carriers can experience acute exacerbations, complicating diagnosis.
- Atypical presentations of hepatitis necessitate broad differential diagnoses.
Observation:
- A patient with chronic hepatitis B presented with fever, jaundice, headache, and arthralgias.
- Liver biopsy showed lipogranulomatous changes, atypical for HBV exacerbation.
- Initial laboratory findings mimicked an HBV flare.
Findings:
- Serological testing confirmed Q fever, caused by Coxiella burnetii.
- The patient demonstrated a positive clinical response to tetracycline treatment.
- This case represents the first reported instance of Q fever presenting as hepatitis in Taiwan.
Implications:
- Q fever should be considered in the differential diagnosis of unexplained hepatitis, especially with atypical liver biopsy findings.
- Early diagnosis and treatment of Q fever with antibiotics like tetracycline can lead to favorable outcomes.
- This case highlights the importance of considering uncommon infectious etiologies in patients with chronic liver disease and acute symptoms.