A case of giant cell arteritis associated with culture-proven Coxiella burnetii aortitis

S. de Worm, J. B. Giot, C. Courtoy, E. Gillet, Sophie Amrane, P. Huynen, M. Van Esbroeck, E. Prudent, H. Lepidi, Matthieu Million, M. Moutschen, Didier Raoult

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    Abstract

    A case of proven Coxiella burnetii aortitis, possibly associated with giant cell arteritis (GCA), is reported. A 72-year-old man, who is a hunter, presented with weight loss, fever, jaw claudication, and hardened temporal arteries associated with a persistent inflammatory syndrome and arteritis of the whole aorta, including the brachiocephalic arteries, as seen on F-18-fluorodeoxyglucose positron emission tomography/computed tomography. The diagnosis of GCA was retained, and treatment with prednisolone was started. Given the aneurysm of the abdominal aorta, the patient underwent replacement of the abdominal aorta with an allograft. Histology showed intense chronic arteritis attributed to atherosclerosis with dissection. However, Coxiella burnetii infection was confirmed by serology and then by culture and molecular biology on the surgical specimen. A combination of hydroxychloroquine and doxycycline was added to tapered prednisolone and the outcome was favourable. (c) 2018 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license.

    Original languageEnglish
    JournalInternational Journal of Infectious Diseases
    Volume69
    Pages (from-to)50-54
    Number of pages5
    ISSN1201-9712
    DOIs
    Publication statusPublished - 2018

    Keywords

    • Coxiella burnetii
    • Giant cell arteritis
    • Aortitis
    • Q fever
    • Vascular infection
    • ACUTE Q-FEVER
    • INFECTION
    • VASCULOPATHY
    • DIAGNOSIS
    • PATIENT

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