Omadacycline in the treatment of severe Q fever pneumonia during an influenza epidemic: a case report with literature review

Q fever, caused by Coxiella burnetii (Q fever rickettsiae), is a zoonotic disease with a natural reservoir and has been reported in many countries and regions. Its clinical presentation is non-specific and easily confused with other infectious or non-infectious diseases. Conventional diagnostic meth...

Full description

Saved in:
Bibliographic Details
Main Authors: Chuanhua Nie, Yuan Zhu, Huajuan Zhou, Xinmin Zhu, Shaohua Hu, Xiaoli Zhao, Xiaohua Zhong, Fengfei Qian, Miao Yu, Qiuting Jiang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1626115/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849340443616083968
author Chuanhua Nie
Yuan Zhu
Huajuan Zhou
Xinmin Zhu
Shaohua Hu
Xiaoli Zhao
Xiaohua Zhong
Fengfei Qian
Miao Yu
Qiuting Jiang
author_facet Chuanhua Nie
Yuan Zhu
Huajuan Zhou
Xinmin Zhu
Shaohua Hu
Xiaoli Zhao
Xiaohua Zhong
Fengfei Qian
Miao Yu
Qiuting Jiang
author_sort Chuanhua Nie
collection DOAJ
description Q fever, caused by Coxiella burnetii (Q fever rickettsiae), is a zoonotic disease with a natural reservoir and has been reported in many countries and regions. Its clinical presentation is non-specific and easily confused with other infectious or non-infectious diseases. Conventional diagnostic methods, such as respiratory specimen culture, often fail to yield conclusive results, increasing the risk of misdiagnosis. This case involves a 78-year-old male patient from Zhejiang Province, China, who presented with fever as the primary complaint and developed severe pneumonia. The diagnosis of H1N1 influenza co-infection with Coxiella burnetii was confirmed by bronchoalveolar lavage fluid targeted high-throughput sequencing (tNGS). Following antiviral treatment with Maraviroc and antibiotic therapy with omadacycline tosilate (a novel tetracycline-class drug) for Coxiella burnetii infection, the patient’s clinical symptoms improved, biochemical markers normalized, and pulmonary imaging showed resolution. This case highlights the potential of tNGS to improve the detection rate of mixed infections in cases of severe pneumonia of unknown etiology. The novel tetracycline drug, such as omadacycline, has demonstrated efficacy against Q fever rickettsial pneumonia, offering a new perspective for clinical diagnosis and treatment.
format Article
id doaj-art-0a69e070fb6741dabdca046e7d31b9c5
institution Kabale University
issn 2296-858X
language English
publishDate 2025-08-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj-art-0a69e070fb6741dabdca046e7d31b9c52025-08-20T03:43:55ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-08-011210.3389/fmed.2025.16261151626115Omadacycline in the treatment of severe Q fever pneumonia during an influenza epidemic: a case report with literature reviewChuanhua NieYuan ZhuHuajuan ZhouXinmin ZhuShaohua HuXiaoli ZhaoXiaohua ZhongFengfei QianMiao YuQiuting JiangQ fever, caused by Coxiella burnetii (Q fever rickettsiae), is a zoonotic disease with a natural reservoir and has been reported in many countries and regions. Its clinical presentation is non-specific and easily confused with other infectious or non-infectious diseases. Conventional diagnostic methods, such as respiratory specimen culture, often fail to yield conclusive results, increasing the risk of misdiagnosis. This case involves a 78-year-old male patient from Zhejiang Province, China, who presented with fever as the primary complaint and developed severe pneumonia. The diagnosis of H1N1 influenza co-infection with Coxiella burnetii was confirmed by bronchoalveolar lavage fluid targeted high-throughput sequencing (tNGS). Following antiviral treatment with Maraviroc and antibiotic therapy with omadacycline tosilate (a novel tetracycline-class drug) for Coxiella burnetii infection, the patient’s clinical symptoms improved, biochemical markers normalized, and pulmonary imaging showed resolution. This case highlights the potential of tNGS to improve the detection rate of mixed infections in cases of severe pneumonia of unknown etiology. The novel tetracycline drug, such as omadacycline, has demonstrated efficacy against Q fever rickettsial pneumonia, offering a new perspective for clinical diagnosis and treatment.https://www.frontiersin.org/articles/10.3389/fmed.2025.1626115/fullQ feverinfluenzatargeted high-throughput sequencing (tNGS)omadacyclinecase
spellingShingle Chuanhua Nie
Yuan Zhu
Huajuan Zhou
Xinmin Zhu
Shaohua Hu
Xiaoli Zhao
Xiaohua Zhong
Fengfei Qian
Miao Yu
Qiuting Jiang
Omadacycline in the treatment of severe Q fever pneumonia during an influenza epidemic: a case report with literature review
Frontiers in Medicine
Q fever
influenza
targeted high-throughput sequencing (tNGS)
omadacycline
case
title Omadacycline in the treatment of severe Q fever pneumonia during an influenza epidemic: a case report with literature review
title_full Omadacycline in the treatment of severe Q fever pneumonia during an influenza epidemic: a case report with literature review
title_fullStr Omadacycline in the treatment of severe Q fever pneumonia during an influenza epidemic: a case report with literature review
title_full_unstemmed Omadacycline in the treatment of severe Q fever pneumonia during an influenza epidemic: a case report with literature review
title_short Omadacycline in the treatment of severe Q fever pneumonia during an influenza epidemic: a case report with literature review
title_sort omadacycline in the treatment of severe q fever pneumonia during an influenza epidemic a case report with literature review
topic Q fever
influenza
targeted high-throughput sequencing (tNGS)
omadacycline
case
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1626115/full
work_keys_str_mv AT chuanhuanie omadacyclineinthetreatmentofsevereqfeverpneumoniaduringaninfluenzaepidemicacasereportwithliteraturereview
AT yuanzhu omadacyclineinthetreatmentofsevereqfeverpneumoniaduringaninfluenzaepidemicacasereportwithliteraturereview
AT huajuanzhou omadacyclineinthetreatmentofsevereqfeverpneumoniaduringaninfluenzaepidemicacasereportwithliteraturereview
AT xinminzhu omadacyclineinthetreatmentofsevereqfeverpneumoniaduringaninfluenzaepidemicacasereportwithliteraturereview
AT shaohuahu omadacyclineinthetreatmentofsevereqfeverpneumoniaduringaninfluenzaepidemicacasereportwithliteraturereview
AT xiaolizhao omadacyclineinthetreatmentofsevereqfeverpneumoniaduringaninfluenzaepidemicacasereportwithliteraturereview
AT xiaohuazhong omadacyclineinthetreatmentofsevereqfeverpneumoniaduringaninfluenzaepidemicacasereportwithliteraturereview
AT fengfeiqian omadacyclineinthetreatmentofsevereqfeverpneumoniaduringaninfluenzaepidemicacasereportwithliteraturereview
AT miaoyu omadacyclineinthetreatmentofsevereqfeverpneumoniaduringaninfluenzaepidemicacasereportwithliteraturereview
AT qiutingjiang omadacyclineinthetreatmentofsevereqfeverpneumoniaduringaninfluenzaepidemicacasereportwithliteraturereview