Gallium-67 citrate imaging before and after treatment of acute Q fever

Q fever is an acute infectious disease caused by the obligate intracellular bacterium Coxiella burnetii. Acute Q fever is most commonly a mild and self-limiting disease with fever, interstitial pneumonia, and hepatitis. Either myocarditis or nephritis is a rare complication of acute Q fever. The authors present a 63-year-old woman with acute onset of high fever, chills, myalgia, headache, and anorexia. A Ga-67 scan showed changes secondary to active inflammation in the myocardium, right breast, liver, kidneys, and knee joints. Under the clinical impression of Q fever, the patient underwent antibiotic treatment with doxycycline. Acute Q fever was diagnosed on the basis of a positive serologic test for C burnetii. A follow-up gallium scan performed 6 weeks after the initial study showed normalization of gallium uptake in the myocardium, right breast, liver, kidneys, and knee joints.