Clinical Report: Severe Multisystem Sepsis Due to Acute Coxiella burnetii Infection
Background
Coxiella burnetii is the causative agent of Q fever, which can present as a severe disseminated illness, especially in immunocompromised individuals. Diagnosis is often complicated by the organism's intracellular nature and the limitations of conventional microbiological tests.
Data Highlights
Metagenomic next-generation sequencing identified C. burnetii nucleic acid sequences in the patient. Following doxycycline treatment, the patient's fever resolved and clinical parameters improved.
Key Findings
A 68-year-old man with rheumatoid arthritis developed severe multisystem sepsis.
Conventional microbiological tests, including blood cultures, were negative.
Metagenomic next-generation sequencing successfully identified C. burnetii.
Targeted treatment with doxycycline led to clinical improvement.
Clinical Implications
Healthcare providers should consider Q fever in immunocompromised patients presenting with severe infections of unknown origin. Metagenomic next-generation sequencing may serve as a valuable diagnostic tool in such cases.
Conclusion
This case demonstrates the potential of mNGS for timely pathogen detection.
Biomarker-guided patient selection may help identify patients with sepsis who could benefit from endotoxin-targeted therapy, although confirmatory evidence is still needed.
