Case 209. 

Electron micrograph of Coxiella burnetti in mouse splenic macrophages
　 　 　 　
　 Small rods are clustered within the cytoplasm of macrophages to form cytoplasmic inclusions. 　
　 　 　 　

　

 　 Chronic Q fever shows features of endocarditis, chronic hepatitis or chronic osteomyelitis. Small epithelioid granuloma (fibrin ring granuloma) is a histologic hallmark of the liver lesion.