Spontaneous splenic rupture: a rare complication of Q fever in Australia
Wade, A.J.; Walker, T.; Athan, E.; Hughes, A.J.
Medical Journal of Australia 184(7): 364
2006
ISSN/ISBN: 0025-729X PMID: 16584375 Document Number: 600245
A 29-year-old male worker of a factory processing animal placentas and fetal products in Chile, presented with 5 days of fever, rigor and severe headache in March 2005. He was febrile and tachycardic on examination and laboratory investigations revealed thrombocytopenia. A provisional diagnosis of Q fever was made based on illness and livestock exposure. He was admitted and treated with empiric doxycycline, penicillin and ceftriaxone. On Day 1 of admission, he developed sudden, severe, left upper quadrant abdominal pain with shoulder tip radiation, diaphoresis and hypotension. Abdominal computed tomography showed splenomegaly and subcapsular splenic haematoma with rupture into the peritoneal space. Acute Q fever was confirmed by polymerase chain reaction on Day 2, and antibiotic therapy was simplified to doxycycline 100 mg twice daily for 14 days. He was discharged from hospital on Day 5 and recovered fully. Seroconversion to Q fever was subsequently confirmed. This is the first case of Q fever associated with spontaneous splenic rupture in Australia.