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Hip periprosthetic joint infection due to Coxiella burnetii in an adult male. IDCases 2022; 31:e01661. [PMID: 36593892 PMCID: PMC9803808 DOI: 10.1016/j.idcr.2022.e01661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/19/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Coxiella burnetii is an obligate intracellular Gram-negative bacterium. "Query fever" (Q fever) first described in 1939 is a disease caused by Coxiella burnetii. This bacterium infects animals including goats, sheep, and cattle, and has been recognized as a pathogen causing acute illness in humans. A patient living on a farm with a history of a right total hip arthroplasty presented with right hip pain. Arthrocentesis revealed a total nucleated count of 4288 (93% neutrophils), however his synovial fluid culture remained negative. His Q fever phase I IgG and phase II IgG were elevated at 1:4096 and 1:2048, respectively. He underwent incision and drainage with exchange of the femoral head and acetabular component, with retention of the femoral stem. PCR of tissue samples returned positive for Coxiella burnettii. He was diagnosed with a persistent localized prosthetic joint infection (PJI) of the right hip. Coxiella burnetii PJI is a rare but increasingly recognized form of persistent localized Q fever infection. Q fever should be considered in the differential diagnosis of culture-negative PJI, especially among patients with exposure to sheep, goats, or cattle. Initial screening for Coxiella burnetii includes serology, but tissue PCR and immunohistochemical staining may be obtained to confirm joint infection.
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Kobayashi T, Chatanga E, Qiu Y, Simuunza M, Kajihara M, Hang’ombe BM, Eto Y, Saasa N, Mori-Kajihara A, Simulundu E, Takada A, Sawa H, Katakura K, Nonaka N, Nakao R. Molecular Detection and Genotyping of Coxiella-Like Endosymbionts in Ticks Collected from Animals and Vegetation in Zambia. Pathogens 2021; 10:pathogens10060779. [PMID: 34205691 PMCID: PMC8234379 DOI: 10.3390/pathogens10060779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/16/2021] [Accepted: 06/19/2021] [Indexed: 01/16/2023] Open
Abstract
Ticks are obligate ectoparasites as they require to feed on their host blood during some or all stages of their life cycle. In addition to the pathogens that ticks harbor and transmit to vertebrate hosts, they also harbor other seemingly nonpathogenic microorganisms including nutritional mutualistic symbionts. Tick nutritional mutualistic symbionts play important roles in the physiology of the host ticks as they are involved in tick reproduction and growth through the supply of B vitamins as well as in pathogen maintenance and propagation. Coxiella-like endosymbionts (CLEs) are the most widespread endosymbionts exclusively reported in ticks. Although CLEs have been investigated in ticks in other parts of the world, there is no report of their investigation in ticks in Zambia. To investigate the occurrence of CLEs, their maintenance, and association with host ticks in Zambia, 175 ticks belonging to six genera, namely Amblyomma, Argas, Haemaphysalis, Hyalomma, Ornithodoros, and Rhipicephalus, were screened for CLEs, followed by characterization of CLEs by multi-locus sequence typing of the five Coxiella housekeeping genes (dnaK, groEL, rpoB, 16S rRNA, and 23S rRNA). The results showed that 45.7% (n = 80) were positive for CLEs. The comparison of the tick 16S rDNA phylogenetic tree with that of the CLEs concatenated sequences showed that there was a strong correlation between the topology of the trees. The results suggest that most of the CLEs have evolved within tick species, supporting the vertical transmission phenomenon. However, the negative results for CLE in some ticks warrants further investigations of other endosymbionts that the ticks in Zambia may also harbor.
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Affiliation(s)
- Toshiya Kobayashi
- Laboratory of Parasitology, Department of Disease Control, Graduate School of Infectious Diseases, Faculty of Veterinary Medicine, Hokkaido University, N 18 W 9, Kita-ku, Sapporo 060-0818, Japan; (T.K.); (E.C.); (K.K.); (N.N.)
| | - Elisha Chatanga
- Laboratory of Parasitology, Department of Disease Control, Graduate School of Infectious Diseases, Faculty of Veterinary Medicine, Hokkaido University, N 18 W 9, Kita-ku, Sapporo 060-0818, Japan; (T.K.); (E.C.); (K.K.); (N.N.)
- Department of Veterinary Pathobiology, Faculty of Veterinary Medicine, Lilongwe University of Agriculture and Natural Resources, Lilongwe P.O. Box 219, Malawi
| | - Yongjin Qiu
- Division of International Research Promotion, International Institute for Zoonosis Control, Hokkaido University, N 20 W10, Kita-ku, Sapporo 001-0020, Japan;
| | - Martin Simuunza
- Department of Diseases Control, School of Veterinary Medicine, The University of Zambia, Lusaka P.O. Box 32379, Zambia; (M.S.); (N.S.); (E.S.); (A.T.); (H.S.)
- Africa Centre of Excellence for Infectious Diseases of Humans and Animals, The University of Zambia, Lusaka P.O. Box 32379, Zambia;
| | - Masahiro Kajihara
- Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, N 20 W10, Kita-ku, Sapporo 001-0020, Japan; (M.K.); (Y.E.); (A.M.-K.)
| | - Bernard Mudenda Hang’ombe
- Africa Centre of Excellence for Infectious Diseases of Humans and Animals, The University of Zambia, Lusaka P.O. Box 32379, Zambia;
- Department of ParaClinical Studies, School of Veterinary Medicine, The University of Zambia, Lusaka P.O. Box 32379, Zambia
| | - Yoshiki Eto
- Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, N 20 W10, Kita-ku, Sapporo 001-0020, Japan; (M.K.); (Y.E.); (A.M.-K.)
| | - Ngonda Saasa
- Department of Diseases Control, School of Veterinary Medicine, The University of Zambia, Lusaka P.O. Box 32379, Zambia; (M.S.); (N.S.); (E.S.); (A.T.); (H.S.)
| | - Akina Mori-Kajihara
- Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, N 20 W10, Kita-ku, Sapporo 001-0020, Japan; (M.K.); (Y.E.); (A.M.-K.)
| | - Edgar Simulundu
- Department of Diseases Control, School of Veterinary Medicine, The University of Zambia, Lusaka P.O. Box 32379, Zambia; (M.S.); (N.S.); (E.S.); (A.T.); (H.S.)
- Macha Research Trust, Choma P.O. Box 630166, Zambia
| | - Ayato Takada
- Department of Diseases Control, School of Veterinary Medicine, The University of Zambia, Lusaka P.O. Box 32379, Zambia; (M.S.); (N.S.); (E.S.); (A.T.); (H.S.)
- Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, N 20 W10, Kita-ku, Sapporo 001-0020, Japan; (M.K.); (Y.E.); (A.M.-K.)
| | - Hirofumi Sawa
- Department of Diseases Control, School of Veterinary Medicine, The University of Zambia, Lusaka P.O. Box 32379, Zambia; (M.S.); (N.S.); (E.S.); (A.T.); (H.S.)
- Division of Molecular Pathobiology, International Institute for Zoonosis Control, Hokkaido University, N 20 W10, Kita-ku, Sapporo 001-0020, Japan
| | - Ken Katakura
- Laboratory of Parasitology, Department of Disease Control, Graduate School of Infectious Diseases, Faculty of Veterinary Medicine, Hokkaido University, N 18 W 9, Kita-ku, Sapporo 060-0818, Japan; (T.K.); (E.C.); (K.K.); (N.N.)
| | - Nariaki Nonaka
- Laboratory of Parasitology, Department of Disease Control, Graduate School of Infectious Diseases, Faculty of Veterinary Medicine, Hokkaido University, N 18 W 9, Kita-ku, Sapporo 060-0818, Japan; (T.K.); (E.C.); (K.K.); (N.N.)
| | - Ryo Nakao
- Laboratory of Parasitology, Department of Disease Control, Graduate School of Infectious Diseases, Faculty of Veterinary Medicine, Hokkaido University, N 18 W 9, Kita-ku, Sapporo 060-0818, Japan; (T.K.); (E.C.); (K.K.); (N.N.)
- Correspondence: ; Tel.: +81-11-706-5196
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Ghanem-Zoubi N, Karram T, Kagna O, Merhav G, Keidar Z, Paul M. Q fever vertebral osteomyelitis among adults: a case series and literature review. Infect Dis (Lond) 2021; 53:231-240. [PMID: 33475036 DOI: 10.1080/23744235.2020.1871508] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Q fever osteoarticular infections are a rare complication of the chronic form of Q fever. We aimed to characterize chronic Q fever vertebral osteomyelitis through our experience and a review of the literature. METHODS Four adult patients with Q fever vertebral osteomyelitis diagnosed in a tertiary hospital in northern Israel between 2016 to 2020 are described. In addition, a 30 years' literature review of Q fever vertebral osteomyelitis, characterizing predisposing factors, clinical presentation, course of disease, treatment and outcomes, was performed. RESULTS Thirty-four adult patients with Q fever vertebral osteomyelitis were identified. The vast majority were male (30/34, 88%) with a mean age of 67.2 ± 10 years. Involvement of the adjacent aorta, likely the origin of the infection, was observed in 23/34 (68%) of the patients, usually among patients with aortic graft or aneurysm. Clinical presentation was insidious and fever was frequently absent. Delayed diagnosis for months to years after symptoms onset was frequently reported. Vascular infections were managed with or without extraction of the infected aneurysm/aorta and graft placement. The outcome was variable with limited follow-up data in most cases. Patients were usually treated with prolonged antimicrobial therapy, most commonly doxycycline and hydroxychloroquine combination therapy. CONCLUSION Q fever should be included in the differential diagnosis of vertebral osteomyelitis in endemic settings, in particular when concomitant adjacent vascular infection exists.
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Affiliation(s)
- Nesrin Ghanem-Zoubi
- Infectious Diseases Institute, Rambam Health Care Campus, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Tony Karram
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.,Department of Vascular Surgery, Rambam Medical Center, Haifa, Israel
| | - Olga Kagna
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.,Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel
| | - Goni Merhav
- Department of Radiology, Rambam Health Care Campus, Haifa, Israel
| | - Zohar Keidar
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.,Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel
| | - Mical Paul
- Infectious Diseases Institute, Rambam Health Care Campus, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
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Sahu R, Rawool DB, Vinod VK, Malik SVS, Barbuddhe SB. Current approaches for the detection of Coxiella burnetii infection in humans and animals. J Microbiol Methods 2020; 179:106087. [PMID: 33086105 DOI: 10.1016/j.mimet.2020.106087] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/14/2020] [Accepted: 10/14/2020] [Indexed: 02/09/2023]
Abstract
Q fever (coxiellosis), caused by Coxiella burnetii, is an emerging or re-emerging zoonotic disease of public health significance and with worldwide distribution. As a causal agent of the one among the 13 global priority zoonoses, having the infectious dose as low as one bacterium, C. burnetii has been regarded as an obligate intracellular bacterial pathogen. The agent has been classified as a Group B bioterrorism agent by the Centre for Disease Control and Prevention (CDC), and the disease is included in the World Organisation for Animal Health (OIE) list of notifiable diseases. It is mainly transmitted through airborne route in humans and animals. Isolation of C. burnetii, using standard routine laboratory culture techniques was impossible until formulation of axenic-based medium. However, it is still to be included among routinely isolated laboratory pathogen, accounting prolonged incubation period (~7 days) and requirement of specific oxygen concentration (2.5% O2). Therefore, indirect diagnostic tools have been mainly used for its diagnosis. So far serology has been mostly used for testing for C. burnetii infection. The detection of C. burnetii DNA by PCR in various clinical samples have also been widely used. The disease has remained largely under-reported, underdiagnosed and as a masked zoonosis; and therefore, needs to be explored through well-planned scientific studies for knowing its true status and likely it impact in humans and animals by employing state-of-the-art diagnostics, identifying its diverse and new host range, as well as risk factors involved in different geo-climatic, behavioural and social settings as well as risk groups. Here, we reviewed the current approaches used for the detection of C. burnetii infection in humans and animals at the population and individual level.
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Affiliation(s)
- Radhakrishna Sahu
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243 122, India
| | - Deepak B Rawool
- ICAR- National Research Centre on Meat, Hyderabad 500 092, India
| | - Valil Kunjukunju Vinod
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243 122, India
| | - S V S Malik
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243 122, India
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Tasnim S, Shirafkan A, Okereke I. Diagnosis and management of sternoclavicular joint infections: a literature review. J Thorac Dis 2020; 12:4418-4426. [PMID: 32944355 PMCID: PMC7475584 DOI: 10.21037/jtd-20-761] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The sternoclavicular joint (SCJ) is anatomically and clinically significant considering its proximity to important neuro-vascular structures like the subclavian vessels and the phrenic nerve. Infections of this joint masquerade multiple disorders, delay diagnosis and spread to the bone and deep tissues. There is no standardized workup and treatment protocol for sternoclavicular joint infections (SCJI) as defined in literature. Here, we review the existing literature to understand the current knowledge of the diagnosis and treatment of SCJI. We searched English publications in PubMed and included clinical trials, case reports, case series, retrospective cohort studies, literature and systematic reviews after excluding non-infectious etiology of SCJ pathologies. There are many risk factors for SCJI, such as immunocompromised status, intravenous drug use, trauma and arthropathies. But a large percentage of patients with disease have none of these risk factors. SCJIs can present with fever, joint swelling, immobility, and rarely with vocal cord palsy or dysphagia. While Staphylococcus aureus causes over 50% of SCJI cases, other pathogens such as Pseudomonas and Mycobacterium are frequently seen. When diagnosed early, the infection can be medically managed with antibiotics or joint aspirations. Most cases of SCJI, however, are diagnosed after extensive spread to soft tissue and bones requiring en-bloc resection with or without a muscle flap. Complications of undertreatment can range from simple abscess formation to mediastinitis, even sepsis. SCJIs are rare but serious infections prompting early detection and interventions. Most cases of SCJI treated adequately show complete resolution in months while retaining maximum functionality. Key features of proper healing include aggressive physiotherapy to prevent adhesive shoulder capsulitis and decreased range of motion.
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Affiliation(s)
- Sadia Tasnim
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Ali Shirafkan
- Division of Cardiothoracic Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Ikenna Okereke
- Division of Cardiothoracic Surgery, University of Texas Medical Branch, Galveston, TX, USA
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Jones C. Brucellosis in an adult female from Fate Bell Rock Shelter, Lower Pecos, Texas (4000-1300 BP). INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2019; 24:252-264. [PMID: 30710889 DOI: 10.1016/j.ijpp.2019.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/20/2018] [Accepted: 01/22/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE This project is a case study discussing the differential diagnosis of multiple osteolytic vertebral lesions typical of brucellosis from an adult female from Fate Bell Rock Shelter in the Lower Pecos, Texas (4000-1300 BP). MATERIALS One middle to late adult female with exceptional preservation of the vertebrae. METHODS All skeletal remains were observed with low power magnification and the vertebrae were examined in greater detail using computed tomography (CT). RESULTS Pathological conditions involving multiple osteolytic vertebral lesions such as tuberculosis, echinococcosis, and neoplastic conditions were reviewed but brucellosis is the most likely diagnosis based on the pattern and distribution of characteristic lesions. CONCLUSIONS Aside from this study, only one other case of brucellosis has been recognized in prehistoric North American hunter-gatherer skeletal remains. SIGNIFICANCE This individual represents the first case of brucellosis in a hunter-gatherer from prehistoric North America diagnosed using both macroscopic skeletal analysis and computed tomography (CT). LIMITATIONS Poor preservation of vertebrae make cross comparison of remains and differential diagnosis difficult. SUGGESTIONS FOR FURTHER RESEARCH Further review and paleopathological research is needed regarding Coxiella burnetti (Q-fever) infection as a possible contributing factor to osteolytic lesions.
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Affiliation(s)
- Christine Jones
- Texas A&M University-Central Texas, 1001 Leadership Place, Killeen, TX, 76549, United States.
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Edwin J, Ahmed S, Verma S, Tytherleigh-Strong G, Karuppaiah K, Sinha J. Swellings of the sternoclavicular joint: review of traumatic and non-traumatic pathologies. EFORT Open Rev 2018; 3:471-484. [PMID: 30237905 PMCID: PMC6134883 DOI: 10.1302/2058-5241.3.170078] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The sternoclavicular joint (SCJ) is an integral part of the shoulder girdle that connects the upper limb to the axial skeleton. Swelling of the SCJ is commonly due to trauma, degeneration, infections and other disease processes that affect synovial joints. This review also focuses on uncommon conditions that could affect the SCJ, including SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome, Friedrich’s disease and Tietze syndrome. The scope of this review is limited to the analysis of the current evidence on the various conditions affecting the SCJ and also to provide an algorithm to manage these conditions.
Cite this article: EFORT Open Rev 2018;3:471-484. DOI: 10.1302/2058-5241.3.170078
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Affiliation(s)
| | - Shahbaz Ahmed
- Pulvertaft Hand Centre, Royal Derby Hospital, Derby, UK
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