{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:57:57Z","timestamp":1790657877098,"version":"4.1.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"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 is a zoonosis caused by\n                    <jats:italic>Coxiella burnetii<\/jats:italic>\n                    . Classic presentations include atypical pneumonia and hepatitis, but bile duct dilation on imaging is rarely described. We report a case of acute Q fever in an urban resident of Chengdu, Sichuan Province, Southwestern China, who presented with cholestatic liver injury and intra- and extrahepatic bile duct dilation, highlighting an unusual manifestation that mimicked biliary tract disease. A 53-year-old man was admitted with persistent high fever (up to 41.8\u2005\u00b0C), headache, chills, and right upper quadrant pain. Laboratory tests showed cholestatic hepatitis (AST 132 U\/L, ALT 110 U\/L, ALP 221 U\/L, GGT 231 U\/L), with normal total and direct bilirubin. Magnetic resonance cholangiopancreatography (MRCP) revealed mild intra- and extrahepatic bile duct dilation without obstruction. The patient had no livestock contact but had been exposed to wild muntjac deer from informal sources. Empiric doxycycline combined with piperacillin-tazobactam led to rapid defervescence and symptom improvement. The diagnosis of acute Q fever was supported by metagenomic next-generation sequencing (mNGS) of peripheral blood, in the absence of confirmatory seroconversion. In this case, bile duct dilation without jaundice was a notable manifestation of the infection. For febrile patients with unexplained cholestasis and bile duct dilation, especially those with a history of contact with wild animals, Q fever should be considered in the differential diagnosis.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1942956","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:35:07Z","timestamp":1790656507000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Q fever with biliary dilatation following contact with muntjac deer: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Wulong","family":"Mao","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Geriatric Respiratory Diseases of Sichuan Higher Education Institutes","place":["Chengdu, Sichuan, China"]},{"name":"School of Clinical Medicine, The First Affiliated Hospital, Chengdu Medical College","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuping","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Geriatric Respiratory Diseases of Sichuan Higher Education Institutes","place":["Chengdu, Sichuan, China"]},{"name":"School of Clinical Medicine, The First Affiliated Hospital, Chengdu Medical College","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinghao","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Geriatric Respiratory Diseases of Sichuan Higher Education Institutes","place":["Chengdu, Sichuan, China"]},{"name":"School of Clinical Medicine, The First Affiliated Hospital, Chengdu Medical College","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenxi","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, The First Affiliated Hospital, Chengdu Medical College","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, School of Clinical Medicine and the First Affiliated Hospital of Chengdu Medical College","place":["Chengdu, Sichuan, China"]},{"name":"School of Laboratory Medicine\/Clinical IVD Joint Research Center of Chengdu Medical College-Maccura Biotechnology, Chengdu Medical College","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Geriatric Respiratory Diseases of Sichuan Higher Education Institutes","place":["Chengdu, Sichuan, China"]},{"name":"School of Clinical Medicine, The First Affiliated Hospital, Chengdu Medical College","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"B1","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 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