Chronic recurrent multifocal Q fever osteomyelitis in children

Joshua Francis, Jenny Robson, David Wong, Mark Walsh, Ivan Astori, David Gill, Clare Nourse

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    13 Citations (Scopus)


    Background: Clinical disease caused by Coxiella burnetii occurs infrequently in children. Chronic Q fever is particularly uncommon and endocarditis is rarely seen. A small number of cases of Q fever osteomyelitis have been described but the pathophysiology is not well understood and optimal treatment is unknown. Methods: We describe a series of cases of chronic recurrent multifocal Q fever osteomyelitis cases diagnosed in children from a single region in Australia. Results: Between 2011 and 2014, 9 cases of chronic recurrent multifocal Q fever osteomyelitis were diagnosed based on clinical findings, suggestive serology and detection of C. burnetii DNA by polymerase chain reaction testing of biopsy samples (8/9). All required surgical management; antibiotic and adjuvant therapies did not appear to be consistently effective and 2 cases had clinical resolution in the absence of directed antimicrobial therapy. Conclusions: Chronic recurrent multifocal osteomyelitis is a rare manifestation of chronic Q fever infection in children. The pathophysiology of this condition is poorly understood, and effective treatment options have not been established.

    Original languageEnglish
    Pages (from-to)972-976
    Number of pages5
    JournalPediatric Infectious Disease Journal
    Issue number9
    Publication statusPublished - 1 Sep 2016


    • children
    • Coxiella burnetii
    • osteomyelitis
    • Q fever


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