Q Fever Hepatitis: Report of a Case
摘要
Q fever, caused by rickettsia organism Coxiella burnetii, has been considered to be primarily a respiratory infection. However, liver abnormalities have been reported in 11-65% of patients. We report a 53-year-old male farmer, who was hospitalized with chief complaints of headaches, chills and fever for 12 days prior to admission Laboratory data showed liver dysfunction. Abdominal sonography showed fatty infiltration of the liver. Endoscopic retrograde cholangiopancreatography (ERCP) disclosed filling defects in the cystic duct. Tc-99m DISIDA cholescintigraphy revealed poor enhancement of the gall bladder. The patient received laparoscopic cholecystectomy under impression of acute cholecystitis. A liver biopsy was done during the procefure. The liver biopsy showed mutiple ”doughnut-like” granuloma. Q fever hepatitis was suspected, which was later confirmed by serologic examination later. After a 2-week treatment with tetracycline, the fever subsided.