Background: Coxiella burnetii is an obligate bacterial pathogen that causes Q fever. Cytomegalovirus (CMV) commonly exists as a latent infection in healthy people. Co-infection with both pathogens is rare. Case presentation: We report an immunocompetent 53-year-old male farmer who presented with fulminant hepatic failure and acute renal failure. Empiric antibiotic treatment with intravenous penicillin G and levofloxacin were given, but hepatic and renal functions continued to deteriorate. A subsequent test of serum immunoglobulin M was positive for CMV, and administration of gancyclovir led to gradual recovery. A diagnosis of acute Q fever was confirmed by indirect immunofluorescence assay (IFA) on paired serum samples to demonstrate a significant rise in antibody titers. Antibiotic treatment was adjusted accordingly. Conclusion: CMV co-infection should be considered in patients with acute Q fever when they do not respond to standard antimicrobial agents.
CITATION STYLE
Hsu, J. Y., Tsai, C. C., & Tseng, K. C. (2014). Fulminant hepatic failure and acute renal failure as manifestations of concurrent Q fever and cytomegalovirus infection: A case report. BMC Infectious Diseases, 14(1). https://doi.org/10.1186/s12879-014-0651-8
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