1. Primary aortoduodenal fistula and chronic Q fever infection.
- Author
-
Do CN, Mar EO, Sim B, and Looke D
- Subjects
- Aged, 80 and over, Anti-Bacterial Agents therapeutic use, Antimalarials therapeutic use, Coxiella burnetii isolation & purification, Doxycycline therapeutic use, Duodenal Diseases surgery, Humans, Hydroxychloroquine therapeutic use, Male, Q Fever drug therapy, Tomography, X-Ray Computed, Aortic Aneurysm, Abdominal complications, Gastrointestinal Hemorrhage etiology, Intestinal Fistula surgery, Q Fever diagnosis, Vascular Fistula surgery
- Abstract
We report a case of chronic Q fever presenting with catastrophic bleeding from an infected abdominal aortic aneurysm causing a primary aortoduodenal fistula in an 80-year-old retired farmer. This presentation is rarely reported in literature and only through case reports. Early diagnosis and definitive surgery were critical to a successful outcome. Serological diagnosis of Q fever was initiated on the patient's past exposure to animal reservoirs. Complicating the case was ongoing gastrointestinal bleeding postsurgery, with multiple endoscopies undertaken before a culprit remnant fistula was found. This case highlights the value in considering Coxiella burnetii as an underlying cause in patients with known risk factors presenting with primary aortoduodenal fistulas. Though rare, it represents a readily treatable cause., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2021
- Full Text
- View/download PDF