© 2012 The Korean Society of Pathologists/The Korean Society for Cytopathology pISSN 1738-1843

Q fever is a worldwide zoonotic disease caused by Coxiella burnetii, an obligate intracellular Gram negative bacterium.1 The main reservoirs are farm animals including cattle, sheep, goats, as well as pets.2 Transmission to humans occurs following inhalation of contaminated aerosols and dusts derived from in-fected animal products or the ingestion of raw milk or fresh goat cheese.2-4 The incubation period is 2-3 weeks after exposure.5 Clinical manifestations of C. burnetii infection are diverse, so the diagnosis can be made systematically. Q fever can be catego-rized into acute and chronic forms.5 Acute Q fever is more com-mon than the chronic form. The acute form commonly presents as a self-limited febrile illness with flu-like symptoms, pneu-monia, and subclinical hepatitis.6 Frank hepatitis with jaundice is rare,3 but hepatomegaly and mildly elevated liver enzyme levels are common. Chronic Q fever can develop months7 or years after acute illness,8 and there may be no history of acute illness. Sixty to seventy percent of the chronic form presents as endocarditis in patients with risk factors such as valvular heart disease, immunocompromised status, and pregnancy.9 Q fever is a rarely developed disease entity in Korea. Accord-ing to a report by the National Institute of Health of Korea, there were 24 cases of Q fever diagnosed by the national reference la-boratory from 2006 to March 2008.10 The most frequent pre-senting symptom of Q fever was fever of unknown origin (FUO). Many studies have described that most common cause of FUO is infectious disease, and useful diagnostic methods are biopies and radiological tests.11 A liver biopsy can be helpful for diag-nosis, particularly in patients with acute Q fever presenting as he patitis. Although fibrin ring granulomas are characteristic in acute Q fever hepatitis,12 details of the pathological features have not been described. Herein, we report the clinical and patholo-gical features of liver biopsies from seven cases of acute Q fever