Case Presentation

A case of coexistent acute severe alcoholic and Q fever hepatitis: The useful contribution of repeated liver biopsies

Lucia Zampaglione, Aurélie Bornand, Nicolas Goossens, Lucas Ramer, Giulia Magini, Marie Ongaro, Andreas Cerny, Laura Rubbia-Brandt, Jean-Louis Frossard and Laurent Spahr*

Published: 23 September, 2022 | Volume 6 - Issue 1 | Pages: 034-038

Acute Q fever is a worldwide zoonotic infection due to C. burnetii that may be associated with hepatitis. Nonspecific clinical and biological manifestations may accompany liver involvement, including hepatomegaly and elevated liver biological tests. However, the presence of jaundice is rare. Therefore, making a diagnosis of Q fever hepatitis may be difficult in an afebrile patient with jaundice of recent onset, altered liver function tests, excessive alcohol intake and no reported contact with animals. We report here the diagnostic work-up and complex clinical management of a patient presenting with acute hepatitis resulting from both C. burnetii infection and severe alcoholic steatohepatitis. Positive serology together with a detailed examination of the liver biopsy was able to reveal the coexistence of both Q fever hepatitis with typical fibrin-ring granulomas as well as florid lesions of alcoholic steatohepatitis. A combination of antibiotics, hydroxychloroquine and steroids, guided by the helpful description of changes in histological alterations on repeated liver biopsies during the course of the disease contributed to the slow but favorable outcome.

Read Full Article HTML DOI: 10.29328/journal.acgh.1001036 Cite this Article Read Full Article PDF


Alcoholic steatohepatitis; Q fever hepatitis; Coxiella burnetii; Fibrin-ring granuloma; Liver biopsy


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  • A case of coexistent acute severe alcoholic and Q fever hepatitis: The useful contribution of repeated liver biopsies
    Lucia Zampaglione, Aurélie Bornand, Nicolas Goossens, Lucas Ramer, Giulia Magini, Marie Ongaro, Andreas Cerny, Laura Rubbia-Brandt, Jean-Louis Frossard and Laurent Spahr* Lucia Zampaglione,Aurélie Bornand,Nicolas Goossens,Lucas Ramer,Giulia Magini,Marie Ongaro,Andreas Cerny,Laura Rubbia-Brandt,Jean-Louis Frossard,Laurent Spahr*. A case of coexistent acute severe alcoholic and Q fever hepatitis: The useful contribution of repeated liver biopsies. . 2022 doi: 10.29328/journal.acgh.1001036; 6: 034-038

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