Granulomatous Hepatitis and Persistent Fever of Unknown Origin: A Case Report

  title={Granulomatous Hepatitis and Persistent Fever of Unknown Origin: A Case Report},
  author={Melissa Magrath and Michelle Pearlman and Lan Peng and William Lee},
  journal={Gastroenterology, Hepatology \& Digestive Disorders},
A 41-year-old man presented with persistent fevers and elevated liver enzymes. Percutaneous liver biopsy revealed fibrin ring granulomas and serologic testing confirmed acute Q fever. Interestingly, his fevers did not resolve with doxycycline alone, and he only clinically improved after hydroxychloroquine was initiated. We discuss the differential diagnosis of fibrinring granulomas on liver biopsy as well as the clinical features and treatment of Q fever. Case Report Citation: Melissa Magrath… 



Clinicopathologic Features of Q Fever Patients with Acute Hepatitis

Because variable-sized circumferential or radiating fibrin deposition was a consistent feature of the present cases, Q fever can be strongly suggested by pathological features and confirmed by serological and/or molecular tests.

Diagnosis and management of Q fever--United States, 2013: recommendations from CDC and the Q Fever Working Group.

  • A. AndersonH. Bijlmer D. Sexton
  • Medicine
    MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports
  • 2013
The first national recommendations issued by CDC for Q fever recognition, clinical and laboratory diagnosis, treatment, management, and reporting for health-care personnel and public health professionals are provided.