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Primary aortoduodenal fistula and chronic Q fever infection
  1. Cuong Nghi Do,
  2. Ethan Oskar Mar,
  3. Beatrice Sim and
  4. David Looke
  1. Department of Infectious Diseases, Princess Alexandra Hospital, Brisbane, Queensland, Australia
  1. Correspondence to Dr Ethan Oskar Mar; ethanmar06{at}


We report a case of chronic Q fever presenting with catastrophic bleeding from an infected abdominal aortic aneurysm causing a primary aortoduodenal fistula in an 80-year-old retired farmer. This presentation is rarely reported in literature and only through case reports. Early diagnosis and definitive surgery were critical to a successful outcome. Serological diagnosis of Q fever was initiated on the patient’s past exposure to animal reservoirs. Complicating the case was ongoing gastrointestinal bleeding postsurgery, with multiple endoscopies undertaken before a culprit remnant fistula was found. This case highlights the value in considering Coxiella burnetii as an underlying cause in patients with known risk factors presenting with primary aortoduodenal fistulas. Though rare, it represents a readily treatable cause.

  • infectious diseases
  • vascular surgery
  • gastrointestinal surgery

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  • Contributors CND undertook drafting the case report, interviewing the patient and obtaining their informed consent. EODM undertook drafting and editing the case report. BS undertook critical revision of the case report. DL undertook overall supervision of the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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