Journal article
Hip periprosthetic joint infection due to Coxiella burnetii in an adult male
IDCases, Vol.31, p.e01661
12/20/2022
DOI: 10.1016/j.idcr.2022.e01661
PMCID: PMC9803808
PMID: 36593892
Abstract
Coxiella burnetii
is an obligate intracellular Gram-negative bacterium. “Query fever” (Q fever) first described in 1939 is a disease caused by
Coxiella burnetii
. This bacterium infects animals including goats, sheep, and cattle, and has been recognized as a pathogen causing acute illness in humans. A patient living on a farm with a history of a right total hip arthroplasty presented with right hip pain. Arthrocentesis revealed a total nucleated count of 4288 (93% neutrophils), however his synovial fluid culture remained negative. His Q fever phase I IgG and phase II IgG were elevated at 1:4096 and 1:2048, respectively. He underwent incision and drainage with exchange of the femoral head and acetabular component, with retention of the femoral stem. PCR of tissue samples returned positive for
Coxiella burnettii
. He was diagnosed with a persistent localized prosthetic joint infection (PJI) of the right hip.
Coxiella burnetii
PJI is a rare but increasingly recognized form of persistent localized Q fever infection. Q fever should be considered in the differential diagnosis of culture-negative PJI, especially among patients with exposure to sheep, goats, or cattle. Initial screening for
Coxiella burnetii
includes serology, but tissue PCR and immunohistochemical staining may be obtained to confirm joint infection
.
•
Coxiella prosthetic joint infection (PJI) is a rare but increasingly recognized form of persistent localized Q fever.
•
Q fever should be considered in the differential diagnosis of culture negative PJI.
•
Synovial tissue PCR can Coxiella PJI and submission of multiple samples can increase diagnostic sensitivity.
•
Treatment of Coxiella PJI includes prolonged doxycycline in combination with hydroxychloroquine.
Details
- Title: Subtitle
- Hip periprosthetic joint infection due to Coxiella burnetii in an adult male
- Creators
- Ian Kidder - University of Iowa Hospitals and Clinics, Department of Internal Medicine, 200 Hawkins Drive, Iowa City, IA 52242, USATakaaki Kobayashi - University of IowaBradley Ford - University of IowaPoorani Sekar - University of Iowa Hospitals and Clinics, Department of Internal Medicine, Division of Infectious Diseases, 200 Hawkins Drive, Iowa City, IA 52242, USA
- Resource Type
- Journal article
- Publication Details
- IDCases, Vol.31, p.e01661
- DOI
- 10.1016/j.idcr.2022.e01661
- PMID
- 36593892
- PMCID
- PMC9803808
- NLM abbreviation
- IDCases
- ISSN
- 2214-2509
- eISSN
- 2214-2509
- Publisher
- Elsevier
- Language
- English
- Date published
- 12/20/2022
- Academic Unit
- Infectious Diseases; Pathology; Internal Medicine
- Record Identifier
- 9984354393202771
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