To report a case of severe multisystem sepsis due to acute Coxiella burnetii infection in an immunocompromised patient and highlight the challenges in diagnosing Q fever and the utility of metagenomic next-generation sequencing (mNGS) for diagnosis.
Approach:
Case Presentation: A 68-year-old man with rheumatoid arthritis on immunosuppressive therapy developed persistent fever, pancytopenia, hepatic dysfunction, and multisystem sepsis. He had no clear epidemiological exposure history, and conventional microbiological tests were negative.
Key Findings:
Coxiella burnetii can cause severe multisystem sepsis, particularly in immunocompromised individuals.
Conventional diagnostic methods may fail to identify C. burnetii in cases of severe infection, leading to diagnostic challenges.
mNGS is a valuable tool for the timely detection of pathogens in complex clinical scenarios.
Interpretation:
This case illustrates the diagnostic challenges associated with Q fever in immunocompromised patients and the potential role of mNGS in identifying pathogens in severe infections.
Limitations:
The case is based on a single patient, limiting generalizability.
No clear epidemiological exposure history was identified, complicating the understanding of transmission.
Conclusion:
The case emphasizes the need for consideration of Q fever in severe culture-negative infections and highlights the diagnostic advantages of mNGS.
