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Case Report: Coxiella burnetii vertebral osteomyelitis in a pigeon breeder: mNGS diagnosis of chronic Q fever

Year: 2025

Type: article

Abstract: Background Isolated vertebral osteomyelitis represents an uncommon manifestation of chronic Q fever, posing significant diagnostic challenges. We report a case of Coxiella burnetii-induced spondylodiscitis confirmed via metagenomic next-generation sequencing (mNGS). Case report A 52-year-old male with occupational avian exposure (pigeon breeder) presented with chronic low back pain persisting for over 1 year, refractory to serial epidural corticosteroid injections. Lumbar MRI demonstrated multifocal osteomyelitis (L3–L5) with associated intraspinal abscess. mNGS analysis of aspirate identified C. burnetii. Targeted dual antimicrobial therapy (vancomycin/doxycycline) induced progressive clinical resolution. Conclusion Coxiella burnetii, the etiological agent of Q fever, exhibits global distribution and poses significant diagnostic challenges. Its clinical manifestations are frequently nonspecific, typically afebrile, and diagnosis is commonly delayed by months to years post-symptom onset. mNGS offers critical diagnostic utility for early identification and therapeutic intervention in rare spinal infections, thereby mitigating complication risks.

Source: Frontiers in Medicine

DOI: 10.3389/fmed.2025.1636778