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Published in: Infection 1/2018

01-02-2018 | Case Report

A case of Q fever with erythema nodosum

Authors: E. Meriglier, L. Asquier, F. Roblot, P. Roblot, C. Landron

Published in: Infection | Issue 1/2018

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Abstract

Background

Acute Q fever is asymptomatic in 60% of the patients, while the reminder may present with fever, pneumoniae, and hepatitis. Skin manifestations are uncommon including transient punctiform rashes, purpuric, or maculopapular eruptions. Erythema nodosum have seldom been reported.

Case presentation

A 37-year-old female presented with fever for 1 month and skin lesions consists of erythematous painful nodule of the legs. Serological testing for Coxiella burnetii was positive. Treatment consisted with doxycycline for 2 weeks. Evolution was favorable. The patient completely recovered and had no evidence of skin lesion 1 month later.

Conclusion

Because of its nonspecific clinical presentation, Q fever with erythema nodosum is probably underestimated. Q fever should be evocated when facing unexplained erythema nodosum even if there is not other typical clinical manifestation of Q fever.
Literature
1.
go back to reference Raoult D, Marrie T. Q fever. Clin Infect Dis Off Publ Infect Dis Soc Am. 1995;20:489–95 (quiz 496).CrossRef Raoult D, Marrie T. Q fever. Clin Infect Dis Off Publ Infect Dis Soc Am. 1995;20:489–95 (quiz 496).CrossRef
2.
go back to reference Raoult D, Tissot-Dupont H, Foucault C, Gouvernet J, Fournier PE, Bernit E, et al. Q fever 1985-1998. Clinical and epidemiologic features of 1,383 infections. Medicine (Baltimore). 2000;79:109–23.CrossRef Raoult D, Tissot-Dupont H, Foucault C, Gouvernet J, Fournier PE, Bernit E, et al. Q fever 1985-1998. Clinical and epidemiologic features of 1,383 infections. Medicine (Baltimore). 2000;79:109–23.CrossRef
3.
go back to reference Madeddu G, Fiore V, Mancini F, Caddeo A, Ciervo A, Babudieri S, et al. Mediterranean spotted fever-like illness in Sardinia, Italy: a clinical and microbiological study. Infection. 2016;44:733–8.CrossRefPubMed Madeddu G, Fiore V, Mancini F, Caddeo A, Ciervo A, Babudieri S, et al. Mediterranean spotted fever-like illness in Sardinia, Italy: a clinical and microbiological study. Infection. 2016;44:733–8.CrossRefPubMed
5.
go back to reference Pinsky RL, Fishbein DB, Greene CR, Gensheimer KF. An outbreak of cat-associated Q fever in the United States. J Infect Dis. 1991;164:202–4.CrossRefPubMed Pinsky RL, Fishbein DB, Greene CR, Gensheimer KF. An outbreak of cat-associated Q fever in the United States. J Infect Dis. 1991;164:202–4.CrossRefPubMed
6.
go back to reference Keijmel SP, Raijmakers RPH, Schoffelen T, Salet MCW, Bleeker-Rovers CP. A fatal case of disseminated chronic Q fever: a case report and brief review of the literature. Infection. 2016;44:677–82.CrossRefPubMedPubMedCentral Keijmel SP, Raijmakers RPH, Schoffelen T, Salet MCW, Bleeker-Rovers CP. A fatal case of disseminated chronic Q fever: a case report and brief review of the literature. Infection. 2016;44:677–82.CrossRefPubMedPubMedCentral
7.
go back to reference Kumpf O, Dohmen P, Ertmer M, Knebel F, Wiessner A, Kikhney J, et al. Rapid molecular diagnosis of infective aortic valve endocarditis caused by Coxiella burnetii. Infection. 2016;44:813–7.CrossRefPubMed Kumpf O, Dohmen P, Ertmer M, Knebel F, Wiessner A, Kikhney J, et al. Rapid molecular diagnosis of infective aortic valve endocarditis caused by Coxiella burnetii. Infection. 2016;44:813–7.CrossRefPubMed
8.
go back to reference Raoult D, Marrie TJ, Mege JL. Natural history and pathophysiology of Q fever. Lancet Infect Dis. 2005;5:219–26.CrossRefPubMed Raoult D, Marrie TJ, Mege JL. Natural history and pathophysiology of Q fever. Lancet Infect Dis. 2005;5:219–26.CrossRefPubMed
9.
go back to reference van Hensbroek MB, de Vries E, Dolan G, Schneeberger P. Rash and petechiae as presenting signs of Q fever. Pediatr Infect Dis J. 2000;19:358.CrossRef van Hensbroek MB, de Vries E, Dolan G, Schneeberger P. Rash and petechiae as presenting signs of Q fever. Pediatr Infect Dis J. 2000;19:358.CrossRef
10.
go back to reference Conget I, Mallolas J, Mensa J, Rovira M. Erythema nodosum and Q fever. Arch Dermatol. 1987;123:867.CrossRefPubMed Conget I, Mallolas J, Mensa J, Rovira M. Erythema nodosum and Q fever. Arch Dermatol. 1987;123:867.CrossRefPubMed
11.
go back to reference Argov O, Weintraub M, Charach G. ‘Doughnut’ granulomas from erythema nodosum in acute Q fever. Isr Med Assoc J IMAJ. 2008;10:241–2.PubMed Argov O, Weintraub M, Charach G. ‘Doughnut’ granulomas from erythema nodosum in acute Q fever. Isr Med Assoc J IMAJ. 2008;10:241–2.PubMed
12.
go back to reference Villar García J, Velat Rafols M, Güerri Fernández R, Garcés Jarque JM. Erythema nodosum secondary to Q fever. Rev Clin Esp. 2008;208:58.CrossRefPubMed Villar García J, Velat Rafols M, Güerri Fernández R, Garcés Jarque JM. Erythema nodosum secondary to Q fever. Rev Clin Esp. 2008;208:58.CrossRefPubMed
13.
go back to reference Vázquez-López F, Rippe ML, Soler T, Rodríguez A, Arribas JM, Pérez-Oliva N. Erythema nodosum and acute Q fever: report of a case with granulomatous hepatitis and immunological abnormalities. Acta Derm Venereol. 1997;77:73–4.PubMed Vázquez-López F, Rippe ML, Soler T, Rodríguez A, Arribas JM, Pérez-Oliva N. Erythema nodosum and acute Q fever: report of a case with granulomatous hepatitis and immunological abnormalities. Acta Derm Venereol. 1997;77:73–4.PubMed
14.
go back to reference Nuño Mateo FJ, Noval Menéndez J, Campoamor Serrano MT, Seguí Riesco ME. Prolonged fever and cutaneous lesions in a 59-year-old woman. Rev Clin Esp. 2002;202:239–40.CrossRefPubMed Nuño Mateo FJ, Noval Menéndez J, Campoamor Serrano MT, Seguí Riesco ME. Prolonged fever and cutaneous lesions in a 59-year-old woman. Rev Clin Esp. 2002;202:239–40.CrossRefPubMed
15.
go back to reference Galache C, Santos-Juanes J, Blanco S, Rodriguez E, Martinez A, Soto J. Q fever: a new cause of ‘doughnut’granulomatous lobular panniculitis. Br J Dermatol. 2004;151:685–7.CrossRefPubMed Galache C, Santos-Juanes J, Blanco S, Rodriguez E, Martinez A, Soto J. Q fever: a new cause of ‘doughnut’granulomatous lobular panniculitis. Br J Dermatol. 2004;151:685–7.CrossRefPubMed
16.
go back to reference Betlloch I, Amador C, Chiner E, Varona C, Carbonell C, Vilar A. Erythema annular centrifugum in Q fever. Int J Dermatol. 1991;30:502.CrossRefPubMed Betlloch I, Amador C, Chiner E, Varona C, Carbonell C, Vilar A. Erythema annular centrifugum in Q fever. Int J Dermatol. 1991;30:502.CrossRefPubMed
17.
go back to reference Herrero F, Campillo J, Torralba M, Pretel L, Palazón D. Dermal vasculitis as the only manifestation of Q fever. Enferm Infecc Microbiol Clin. 1991;9:380.PubMed Herrero F, Campillo J, Torralba M, Pretel L, Palazón D. Dermal vasculitis as the only manifestation of Q fever. Enferm Infecc Microbiol Clin. 1991;9:380.PubMed
Metadata
Title
A case of Q fever with erythema nodosum
Authors
E. Meriglier
L. Asquier
F. Roblot
P. Roblot
C. Landron
Publication date
01-02-2018
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 1/2018
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-017-1058-4

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