{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:02:53Z","timestamp":1789448573579,"version":"build-2803163510"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004775","name":"Natural Science Foundation of Gansu Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004775","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aims to characterize Q fever vertebral osteomyelitis based on our experience and literature review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>By reviewing all reported cases of Q fever vertebral osteomyelitis since the 21st century, we characterized the exposure history, clinical presentations, treatment strategies, and prognostic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty cases of Q fever vertebral osteomyelitis were identified. The mean age was 63.4\u202f\u00b1\u202f15.7\u202fyears, and 86% (43\/50) of the participants were male. Of the 50 patients, 21 had a history of contact with cattle, sheep, or wild animals, and of the 43 patients, 26 had vascular comorbidities. Low back pain (39\/45) was the most common symptom. The lumbar spine was the most susceptible region, with the L4\u2013L5 segment being the most frequently involved site. Of the 47 patients, 39 had multivertebral infections, and the majority also had psoas abscesses (25\/41). The positive rate of next-generation sequencing (NGS; 7\/7) in spinal lesion tissues was the highest, followed by that of polymerase chain reaction (PCR) detection (26\/30). The most common treatment regimen was doxycycline combined with hydroxychloroquine (31\/49). The proportions of patients with fever (36% vs. 5.9%) and elevated C-reactive protein (CRP; 90% vs. 41.7%) levels were higher in the group of patients with vertebral osteomyelitis and those with concurrent vascular defects (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). However, separate comparative analyses of the two subgroups showed no significant difference in overall outcomes (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;gt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Q fever vertebral osteomyelitis should be included in the differential diagnosis, particularly in older men and patients with concurrent vascular defects. PCR or NGS performed on local specimens provides critical advantages for rapid pathogen identification. Doxycycline combined with hydroxychloroquine remains the most used treatment regimen at present.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1938416","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:26:40Z","timestamp":1789446400000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical features of Q fever vertebral osteomyelitis: case reports and literature review"],"prefix":"10.3389","volume":"13","author":[{"given":"Tao","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese PLA","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong Liang","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese PLA","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese PLA","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song Kai","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese PLA","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e0287846","DOI":"10.1371\/journal.pone.0287846","article-title":"Incidence and treatment trends of infectious spondylodiscitis in South Korea: A nationwide population-based study","volume":"18","author":"Son","year":"2023","journal-title":"PLoS One"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"20225","DOI":"10.1038\/s41598-023-47341-z","article-title":"Epidemiological trends of pyogenic spondylodiscitis in Germany: an EANS spine section study","volume":"13","author":"Kramer","year":"2023","journal-title":"Sci Rep"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.jiph.2010.01.001","article-title":"Pyogenic spondylodiscitis: An overview","volume":"3","author":"Skaf","year":"2010","journal-title":"J Infect Public Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1080\/23744235.2024.2438826","article-title":"Vertebral osteomyelitis: a comparative, single-center study in northwestern China","volume":"57","author":"Yu","year":"2024","journal-title":"Infect Dis"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1055\/s-0040-1710594","article-title":"Q Fever (Coxiella Burnetii)","volume":"41","author":"Espa\u00f1a","year":"2020","journal-title":"Semin Respir Crit Care Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"43","DOI":"10.32394\/pe.74.05","article-title":"Coxiella burnetii and Q fever - 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