We report 2 cases of chronic Q fever osteomyelitis in 10- and 5-year-old girls who presented with distal right femoral and left parasternal granulomatous osteomyelitis, respectively. Both were treated with ciprofloxacin and rifampin with good response. Q fever osteomyelitis is a challenging diagnosis in children, and the choice of antimicrobial treatment is difficult because of limited available data.
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From the *Infecciology Unit, Pediatric Department, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central - Entidade Pública Empresarial, Lisbon, Portugal; †Pediatric Department, Hospital José Joaquim Fernandes - Unidade Local de Saúde do Baixo Alentejo - Beja, Portugal; ‡Centro de Estudos de Vectores e Doenças Infecciosas, Instituto Nacional de Saúde Dr Ricardo Jorge, Águas de Moura, Portugal; and §Orthopedic Unit, Pediatric Cirurgic Departement, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central - Entidade Pública Empresarial, Lisbon, Portugal.
Accepted for publication May 28, 2015.
The molecular testing, isolation attempts and part of the serological follow-up were supported by the FCT project PTDC/SAU-SAP/115266/2009.
The authors have no funding or conflicts of interest to disclose.
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Address for correspondence: Catarina Gouveia, MD, Pediatria Médica – Hospital Dona Estefânia, Rua Jacinta Marto – 1169 – 045 Lisboa, Portugal. E-mail: email@example.com.