PMC9157756_01
Brain magnetic resonance imaging done on the first hospital day. T1WI/T2WI/Post-Contrast T1WI didn't show any abnormality.
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F1
Brain MRI (Figure 1), lung CT, and Doppler echocardiography showed no abnormalities.
Repeated mNGS of blood results of the patient. The coverage and proportion of Coxiella burnetii detected by mNGS in blood (A) and reexamined mNGS in blood (B). mNGS, metagenomics next-generation sequencing.
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F2
Blood mNGS detected 20 reads of C. burnetii on day 3 (Figure 2A) but CSF mNGS turned to a negative result. Therefore, the diagnosis of acute Q fever had been proven by a positive of the second mNGS analysis of blood [10 unique reads of C. burnetii (Figure 2B)] and a good response to doxycycline.
Longitudinal analysis of temperature and medication. After using specific drugs:doxycycline, the temperature was under control and didn't bounce back again.
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F3
Empiric acyclovir and moxifloxacin had been stopped due to the definitive diagnosis (Figure 3).