{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T05:18:59Z","timestamp":1787548739734,"version":"build-2736575974"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    Q fever, caused by\n                    <jats:italic>Coxiella burnetii<\/jats:italic>\n                    , rarely presents as severe disseminated disease, and timely diagnosis can be difficult because clinical manifestations are nonspecific and routine microbiological tests are often unrevealing. We report a 68-year-old man with rheumatoid arthritis receiving long-term immunosuppressive therapy who presented with persistent unexplained fever, pancytopenia, hepatic dysfunction, polyserosal effusions, and sepsis with multisystem involvement, without a clear epidemiological exposure history. Blood cultures and routine respiratory pathogen testing were negative. Peripheral-blood metagenomic next-generation sequencing (mNGS) detected\n                    <jats:italic>C. burnetii<\/jats:italic>\n                    nucleic acid sequences, and subsequent antibody testing and targeted qPCR supported the diagnosis of acute Q fever with disseminated manifestations. Doxycycline-based targeted therapy was followed by defervescence and marked clinical and laboratory improvement. This case suggests that, in selected immunocompromised patients with severe infection and persistently negative conventional investigations, mNGS may serve as an adjunctive tool to facilitate timely pathogen identification and guide targeted antimicrobial therapy.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1899347","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T04:23:12Z","timestamp":1787545392000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute Coxiella burnetii infection presenting as sepsis with multisystem involvement in an immunosuppressed patient: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Yaozong","family":"Xia","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, The Second People\u2019s Hospital of Yibin","place":["Yibin, China"]},{"name":"Clinical Research and Translational Center, The Second People\u2019s Hospital of Yibin-West China Yibin Hospital, Sichuan University","place":["Yibin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Second People\u2019s Hospital of Yibin","place":["Yibin, China"]},{"name":"Clinical Research and Translational Center, The Second People\u2019s Hospital of Yibin-West China Yibin Hospital, Sichuan University","place":["Yibin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiu","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Second People\u2019s Hospital of Yibin","place":["Yibin, China"]},{"name":"Clinical Research and Translational Center, The Second People\u2019s Hospital of Yibin-West China Yibin Hospital, Sichuan University","place":["Yibin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuxiang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Second People\u2019s Hospital of Yibin","place":["Yibin, China"]},{"name":"Clinical Research and Translational Center, The Second People\u2019s Hospital of Yibin-West China Yibin Hospital, Sichuan University","place":["Yibin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Nie","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Second People\u2019s Hospital of Yibin","place":["Yibin, China"]},{"name":"Clinical Research and Translational Center, The Second People\u2019s Hospital of Yibin-West China Yibin Hospital, Sichuan University","place":["Yibin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"ref1","first-page":"1","article-title":"Diagnosis and management of Q fever--United States, 2013: recommendations from CDC and the Q fever working group","volume":"62","author":"Anderson","year":"2013","journal-title":"MMWR Recomm Rep"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1128\/CMR.00045-16","article-title":"From Q fever to Coxiella burnetii infection: a paradigm change","volume":"30","author":"Eldin","year":"2017","journal-title":"Clin Microbiol Rev"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2495842","DOI":"10.1080\/21505594.2025.2495842","article-title":"Pathogenicity and virulence of Coxiella burnetii: focus on Q 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