A case of giant cell arteritis associated with culture-proven Coxiella burnetii aortitis

S. De Worm (1) , J. B. Giot (1) , C. Courtoy , E. Gillet , Sophie Amrane (2) , P. Huynen (1) , M. van Esbroeck , E. Prudent (2) , H. Lepidi (2) , Matthieu Million (2) , M. Moutschen (1) , Didier Raoult (2)

1 CHU-Liège - Centre Hospitalier Universitaire de Liège
2 MEPHI - Microbes évolution phylogénie et infections

A case of proven Coxiella burnetii aortitis, possibly associated with giant cell arteritis (GCA), is reported. A 72-year-old man, who is a hunter, presented with weight loss, fever, jaw claudication, and hardened temporal arteries associated with a persistent inflammatory syndrome and arteritis of the whole aorta, including the brachiocephalic arteries, as seen on F-18-fluorodeoxyglucose positron emission tomography/computed tomography. The diagnosis of GCA was retained, and treatment with prednisolone was started. Given the aneurysm of the abdominal aorta, the patient underwent replacement of the abdominal aorta with an allograft. Histology showed intense chronic arteritis attributed to atherosclerosis with dissection. However, Coxiella burnetii infection was confirmed by serology and then by culture and molecular biology on the surgical specimen. A combination of hydroxychloroquine and doxycycline was added to tapered prednisolone and the outcome was favourable.

Mots clés: Coxiella burnetii; Giant cell arteritis; Aortitis; Q fever; Vascular infection

Domaines: Maladies infectieuses

S. De Worm, J. B. Giot, C. Courtoy, E. Gillet, Sophie Amrane, et al.. A case of giant cell arteritis associated with culture-proven Coxiella burnetii aortitis. International Journal of Infectious Diseases, 2018, 69, pp.50-54. ⟨10.1016/j.ijid.2018.01.028⟩. ⟨hal-01791589⟩