Acase of Q fever encephalitis was misdiagnosed as tuberculous meningitis
MA Hongyan
ZHANG Guoli
YANG Lei
WU Jinfu
Abstract：Q fever manifests with diverse and nonspecific clinical presentations,primarily characterized by high fever,headache,myalgia,and generalized fatigue.The pathogen can disseminate through small blood vessels and capillaries to involve multiple organ systems including the heart,liver,spleen,kidneys,and brain.This article reports a rare case of Q fever encephalitis in which cerebrospinal fluid(CSF)examination revealed changes consistent with tuberculous meningitis,including lymphocytic pleocytosis,elevated protein,and decreased glucose.Although the interferon-gamma release assay(IGRA)was confirmed by metagenomic next-generation sequencing(mNGS)of CSF,which detected Coxiella burnetii nucleic acid sequences.Treatment with doxycycline combined with rifampin resulted in normalization of CSF parameters and significant clinical improvement.This case highlights that Q fever should be considered in patients with suspected central nervous system infections refractory to conventional therapy,and prompt application of mNGS technology can enhance diagnostic accuracy.
Keywords：Q fever encephalitisCoxiella burnetiimisdiagnosetuberculous meningitis
Publication Date：2025-08-30
Online Publishing Date：2025-08-28(First online date of this platform, not the publication date of the document)
Pages：4( 413-416 )