Chronic recurrent multifocal Q fever osteomyelitis in children

Francis, Joshua R., Robson, Jennifer, Wong, David, Walsh, Mark, Astori, Ivan, Gill, David and Nourse, Clare (2016) Chronic recurrent multifocal Q fever osteomyelitis in children. Pediatric Infectious Disease Journal, 35 9: 972-976. doi:10.1097/INF.0000000000001211


Author Francis, Joshua R.
Robson, Jennifer
Wong, David
Walsh, Mark
Astori, Ivan
Gill, David
Nourse, Clare
Title Chronic recurrent multifocal Q fever osteomyelitis in children
Journal name Pediatric Infectious Disease Journal   Check publisher's open access policy
ISSN 1532-0987
0891-3668
Publication date 2016-09-01
Sub-type Article (original research)
DOI 10.1097/INF.0000000000001211
Open Access Status Not yet assessed
Volume 35
Issue 9
Start page 972
End page 976
Total pages 5
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
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.
Formatted abstract
Background: 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.

Methods: We describe a series of cases of chronic recurrent multifocal Q fever osteomyelitis cases diagnosed in children from a single region in Australia.

Results: 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.

Conclusions: 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.
Keyword Children
Coxiella burnetii
Osteomyelitis
Q fever
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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