Q fever hepatitis: clinical manifestations and pathological findings.

This report describes the clinical manifestations and pathological findings in 5 patients with serologically diagnosed acute Q fever. Each patient presented with headache, malaise, spiking fever, and hepatitis. Percutaneous biopsy of the liver in 4 patients revealed granulomatous changes with many lesions containing a dense fibrin ring surrounding a central lipid vacuole. Biopsy of the bone marrow in the fifth patient revealed similar abnormalities. These lipogranulomas should be considered characteristic of Q fever.