Histological characteristics of the abdominal aortic wall in patients with vascular chronic Q fever |
| |
Authors: | Julia C J P Hagenaars Olivier H J Koning Ronald F F van den Haak Bart A N Verhoeven Nicole H M Renders Mirjam H A Hermans Peter C Wever Robert Jan van Suylen |
| |
Institution: | 1. Department of Surgery, Jeroen Bosch Hospital, , ‘s‐Hertogenbosch, the Netherlands;2. Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, , ‘s‐Hertogenbosch, The Netherlands;3. Molecular Diagnostics, Jeroen Bosch Hospital, , ‘s‐Hertogenbosch, The Netherlands;4. Department of Pathology, Jeroen Bosch Hospital, , ‘s‐Hertogenbosch, The Netherlands |
| |
Abstract: | The aim of this study was to describe specific histological findings of the Coxiella burnetii‐infected aneurysmal abdominal aortic wall. Tissue samples of the aneurysmal abdominal aortic wall from seven patients with chronic Q fever and 15 patients without evidence of Q fever infection were analysed and compared. Chronic Q fever was diagnosed using serology and tissue PCR analysis. Histological sections were stained using haematoxylin and eosin staining, Elastica van Gieson staining and immunohistochemical staining for macrophages (CD68), T lymphocytes (CD3), T lymphocyte subsets (CD4 and CD8) and B lymphocytes (CD20). Samples were scored by one pathologist, blinded for Q fever status, using a standard score form. Seven tissue samples from patients with chronic Q fever and 15 tissue samples from patients without Q fever were collected. Four of seven chronic Q fever samples showed a necrotizing granulomatous response of the vascular wall, which was characterized by necrotic core of the arteriosclerotic plaque (P = 0.005) and a presence of high numbers of macrophages in the adventitia (P = 0.007) distributed in typical palisading formation (P = 0.005) and surrounded by the presence of high numbers of T lymphocytes located diffusely in media and adventitia. Necrotizing granulomas are a histological finding in the C. burnetii‐infected aneurysmal abdominal aortic wall. Chronic Q fever should be included in the list of infectious diseases with necrotizing granulomatous response, such as tuberculosis, cat scratch disease and syphilis. |
| |
Keywords: | aneurysm chronic Q fever granulomatous disease infection vascular disease |
|
|