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This case report aims to highlight the diagnostic challenges of chronic Q fever, mimicking other diseases.

November 18, 2025Frontiers in MedicineOpen Access

Case Report: Chronic Q fever mimicking malignancy and tuberculosis in a hemodialysis patient: multidisciplinary diagnosis guided by metagenomic next-generation sequencing

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This case report aims to highlight the diagnostic challenges of chronic Q fever, mimicking other diseases.
Presented a case of a 50-year-old woman on hemodialysis with abdominal discomfort and myalgia.
Utilized PET-CT imaging for initial evaluation and conducted histopathology on biopsies.
Implemented metagenomic next-generation sequencing to identify the pathogen after misdiagnosis.
PET-CT suggested metastatic malignancy due to hypermetabolic lesions, leading to an initial misdiagnosis.
Metagenomic sequencing confirmed the presence of Coxiella burnetii after treatment for tuberculosis was ineffective.
Targeted doxycycline therapy resulted in sustained clinical improvement and lesion resolution at follow-up.

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Case report reveals chronic q fever misdiagnosed as malignancy in a hemodialysis patient, highlighting critical role of molecular diagnostics.

Huang et al. (2025) studied this question.

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Case report reveals chronic q fever misdiagnosed as malignancy in a hemodialysis patient, highlighting critical role of molecular diagnostics.