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Chronic Q Fever in a renal transplant recipient: a case report.

Abstract
Q fever is a zoonosis caused by Coxiella burnetii that presents with a wide spectrum of acute and chronic manifestations. Progression to chronic Q fever is frequently associated with valve and vascular prosthesis, aneurisms, pregnancy, immunosuppression, and advanced chronic kidney disease. We present a case of a kidney transplant recipient with persistent fever of unknown origin, negative blood cultures, anemia, and increased erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Q fever serological tests were suggestive of chronic Q fever and the patient was diagnosed with probable chronic Q fever according to the Dutch Fever Consensus Group Guidelines. Initiation of doxycycline 200 mg/d and hydroxychloroquine 600 mg/d resulted in clinical remission. Chronic Q fever is a high-morbidity and -mortality disease if untreated and special attention has to be given to high-risk patients, such as kidney transplant recipients.
AuthorsI Godinho, E L Nogueira, C M Santos, S E Paulo, A Fortes, J O Guerra, A Gomes da Costa
JournalTransplantation proceedings (Transplant Proc) Vol. 47 Issue 4 Pg. 1045-7 (May 2015) ISSN: 1873-2623 [Electronic] United States
PMID26036515 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright © 2015 Elsevier Inc. All rights reserved.
Chemical References
  • Anti-Bacterial Agents
  • Antibodies, Bacterial
  • Doxycycline
Topics
  • Anti-Bacterial Agents (therapeutic use)
  • Antibodies, Bacterial (analysis)
  • Coxiella burnetii (immunology)
  • Doxycycline (therapeutic use)
  • Humans
  • Kidney Transplantation
  • Male
  • Middle Aged
  • Postoperative Complications
  • Q Fever (drug therapy, etiology, microbiology)
  • Serologic Tests

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