<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0872-671X</journal-id>
<journal-title><![CDATA[Medicina Interna]]></journal-title>
<abbrev-journal-title><![CDATA[Medicina Interna]]></abbrev-journal-title>
<issn>0872-671X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Medicina Interna]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0872-671X2025000400039</article-id>
<article-id pub-id-type="doi">10.24950/rspmi.2616</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Q Fever with Isolated Bone Marrow Involvement]]></article-title>
<article-title xml:lang="pt"><![CDATA[Febre Q com Envolvimento Isolado da Medula Óssea]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguiar]]></surname>
<given-names><![CDATA[Joana Reis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gonçalves]]></surname>
<given-names><![CDATA[João Ananias]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martins]]></surname>
<given-names><![CDATA[Alfredo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Magalhães]]></surname>
<given-names><![CDATA[Luís]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital da Luz - Arrábida Serviço de Medicina Interna ]]></institution>
<addr-line><![CDATA[Vila Nova de Gaia ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Unidade Local de Saúde do Oeste - Hospital de Torres Vedras Serviço de Medicina Interna ]]></institution>
<addr-line><![CDATA[Torres Vedras ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<volume>32</volume>
<numero>4</numero>
<fpage>39</fpage>
<lpage>42</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0872-671X2025000400039&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0872-671X2025000400039&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0872-671X2025000400039&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract A 71-year-old man presented to the emergency department with 3 weeks of fever, asthenia and night sweats. The initial laboratory results showed mild anaemia, thrombocytopenia and elevated C-reactive protein, with normal liver enzymes. The remaining initial study was unremarkable. Due to haematologic abnormalities, a bone marrow biopsy was performed, revealing multiple ring epithelioid granulomas, consisting of a central lipid vacuole surrounded by epithelioid cells and some neutrophils. These findings, although not pathognomonic, favoured the diagnosis of Q fever with isolated bone marrow involvement. The diagnosis was later confirmed by seroconversion and exclusion of other causes for this histopathologic finding. The patient was treated with doxycycline for fourteen days with a good response and no evidence of the disease after six months.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo Homem de 71 anos recorreu ao serviço de urgência com 3 semanas de febre, astenia e suores nocturnos. Os resultados laboratoriais iniciais mostraram anemia ligeira, trombocitopenia e elevação da proteína C reativa, com enzimas hepáticas normais. O restante estudo inicial foi inconclusivo. Devido às anomalias hematológicas, foi realizada biópsia da medula óssea que revelou múltiplos granulomas epitelioides em anel, que consistiam num vacúolo lipídico central rodeado por células epitelioides e alguns neutrófilos. Estes achados, embora não patognomónicos, favoreceram o diagnóstico de febre Q com envolvimento isolado da medula óssea. O diagnóstico foi posteriormente confirmado com seroconversão e exclusão de outras causas para este achado histopatológico. O paciente foi tratado com doxiciclina durante catorze dias, com boa resposta e sem evidência da doença ao fim de seis meses.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Bone Marrow]]></kwd>
<kwd lng="en"><![CDATA[Coxiella burnetii]]></kwd>
<kwd lng="en"><![CDATA[Q Fever/complications.]]></kwd>
<kwd lng="pt"><![CDATA[Coxiella burnetii]]></kwd>
<kwd lng="pt"><![CDATA[Febre Q/complicações]]></kwd>
<kwd lng="pt"><![CDATA[Medula Óssea]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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