Two cases of q-Fever in hairy cell leukemia

Area of Science:

• Hematology
• Infectious Diseases
• Oncology

Background:

• Hairy cell leukemia (HCL) is a rare B-cell neoplasm.
• HCL patients exhibit significant susceptibility to infections.
• Q-fever, caused by Coxiella burnetii (CB), is an infection that can present unusually in immunocompromised individuals.

Purpose of the Study:

• To report two cases of Q-fever presenting as the initial manifestation in patients with HCL.
• To discuss the clinical course, treatment challenges, and outcomes of these patients.
• To raise awareness of Q-fever as a potential presenting infection in HCL.

Main Methods:

• Case report of two patients diagnosed with HCL.
• Description of clinical presentation, diagnostic workup, and treatment protocols for both Q-fever and HCL.
• Analysis of treatment response and patient outcomes.

Main Results:

• Two HCL patients presented with Q-fever as their first disease manifestation.
• Patients showed a slow response to ciprofloxacin for Q-fever, likely due to immunodeficiency.
• Successful HCL treatment with cladribine post-Q-fever resolution resulted in complete remission.

Conclusions:

• Q-fever should be considered in febrile HCL patients, particularly in endemic areas.
• The potential for chronic infection in HCL patients warrants attention.
• Further case reporting is encouraged to better understand the association between CB infection and HCL.