Clinicopathologic Features of Q Fever Patients with Acute Hepatitis.
10.4132/KoreanJPathol.2012.46.1.10
- Author:
Miji LEE
1
;
Jae Jeong JANG
;
Yang Soo KIM
;
Sang Oh LEE
;
Sang Ho CHOI
;
Sung Han KIM
;
Eunsil YU
Author Information
1. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. esyu@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Coxiella burnetii;
Q fever;
Hepatitis;
Liver biopsy;
Granuloma
- MeSH:
Anti-Bacterial Agents;
Biopsy;
Cholangitis;
Coxiella burnetii;
Eosinophils;
Fever;
Fibrin;
Granuloma;
Hepatitis;
Humans;
Hyperbilirubinemia;
Liver;
Q Fever
- From:Korean Journal of Pathology
2012;46(1):10-14
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Q fever caused by Coxiella burnetii presents with diverse clinical and pathological features including subclinical or cholestatic hepatitis. However, the pathological features of liver biopsies from patients with Q fever have not been well described. METHODS: Clinical features and pathological findings of liver biopsies were reviewed in seven cases of Q fever that were confirmed by serological, microbiological, or molecular tests. RESULTS: All cases presented with fever. Liver enzymes were mildly elevated except one case with marked hyperbilirubinemia. Characteristic fibrin ring granulomas were present in three cases, epithelioid granulomas with eosinophilic infiltration in two cases, extensive extravasated fibrins without ring configuration mimicking necrotizing granuloma in one case, and acute cholangitis without granuloma in one case. All cases were treated with antibiotics for 20 days. Six cases were completely cured, but one suffered from multiorgan failure. CONCLUSIONS: C. burnetii infection is uncommon, but should always be considered in patients with acute hepatitis and fever. Because variable-sized circumferential or radiating fibrin deposition was a consistent feature of the present cases, Q fever can be strongly suggested by pathological features and confirmed by serological and/or molecular tests.
