AUTHOR=Song Minghui , Guo Yumei , Hao Jiahao , Zheng Cuiying , Zuo Huifen , Ye Jiaqing , Zhang Chenfeng , Chen Feilong , Feng Zhongjun , Zhang Hong , Zhao Zhenjun , Gao Weili , Zhang Lijie 
  
TITLE=Case Report: Coxiella burnetii vertebral osteomyelitis in a pigeon breeder: mNGS diagnosis of chronic Q fever
  
JOURNAL=Frontiers in Medicine
  
VOLUME=Volume 12 - 2025
  
YEAR=2025
  
URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1636778
  
DOI=10.3389/fmed.2025.1636778
  
ISSN=2296-858X
  
ABSTRACT=BackgroundIsolated vertebral osteomyelitis represents an uncommon manifestation of chronic Q fever, posing significant diagnostic challenges. We report a case of Coxiella burnetii-induced spondylodiscitis confirmed via metagenomic next-generation sequencing (mNGS).Case reportA 52-year-old male with occupational avian exposure (pigeon breeder) presented with chronic low back pain persisting for over 1 year, refractory to serial epidural corticosteroid injections. Lumbar MRI demonstrated multifocal osteomyelitis (L3–L5) with associated intraspinal abscess. mNGS analysis of aspirate identified C. burnetii. Targeted dual antimicrobial therapy (vancomycin/doxycycline) induced progressive clinical resolution.ConclusionCoxiella burnetii, the etiological agent of Q fever, exhibits global distribution and poses significant diagnostic challenges. Its clinical manifestations are frequently nonspecific, typically afebrile, and diagnosis is commonly delayed by months to years post-symptom onset. mNGS offers critical diagnostic utility for early identification and therapeutic intervention in rare spinal infections, thereby mitigating complication risks.