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Title: Chronic Recurrent Multifocal Q Fever Osteomyelitis in Children: An Emerging Clinical Challenge.
Authors: Francis, Joshua R
Robson, Jennifer
Wong, David
Walsh, Mark
Astori, Ivan
Gill, David
Nourse, Clare
Affiliation: From the *Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; †Northern Territory Medical Program, Flinders University, Darwin, Northern Territory, Australia, ‡Department of Paediatrics, Royal Darwin Hospital, Darwin, Northern Territory, Australia; §Department of Microbiology, Sullivan Nicolaides Pathology, Brisbane, Queensland, Australia; ¶Department of Histopathology, Mater Pathology, Brisbane, Queensland, Australia; ‖Department of Radiology, **Department of Orthopaedics, Lady Cilento Children's Hospital, Brisbane, Queensland; ††Department of Orthopaedics, John Hunter Hospital, Newcastle, New South Wales, Australia; ‡‡Paediatric Infection Management and Prevention, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia; and §§Faculty of Paediatrics and Child Health, University of Queensland, Brisbane, Queensland, Australia..
Issue Date: 2016
Citation: The Pediatric infectious disease journal 2016; 35(9): 972-6
Abstract: Clinical disease caused by Coxiella burnetii occurs infrequently in children. Chronic Q fever is particularly uncommon and endocarditis is rarely seen. A small number of cases of Q fever osteomyelitis have been described but the pathophysiology is not well understood and optimal treatment is unknown. We describe a series of cases of chronic recurrent multifocal Q fever osteomyelitis cases diagnosed in children from a single region in Australia. Between 2011 and 2014, 9 cases of chronic recurrent multifocal Q fever osteomyelitis were diagnosed based on clinical findings, suggestive serology and detection of C. burnetii DNA by polymerase chain reaction testing of biopsy samples (8/9). All required surgical management; antibiotic and adjuvant therapies did not appear to be consistently effective and 2 cases had clinical resolution in the absence of directed antimicrobial therapy. Chronic recurrent multifocal osteomyelitis is a rare manifestation of chronic Q fever infection in children. The pathophysiology of this condition is poorly understood, and effective treatment options have not been established.
DOI: 10.1097/INF.0000000000001211
Type: Journal Article
Subjects: Anti-Bacterial Agents
Child, Preschool
Cohort Studies
Coxiella burnetii
Q Fever
Treatment Outcome
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