Q fever: Difference between revisions

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==Clinical Features==
==Clinical Features==
* Symptoms usually develop within 2-3 weeks, although up to half of those infected may not show symptoms
* Symptoms usually develop within 2-3 weeks, although up to half of those infected may not show symptoms
** high fevers (up to 104-105°F)
** high [[fevers]] (up to 104-105°F)
** severe headache
** severe [[headache]]
** general malaise
** general malaise
** myalgias
** myalgias
** chills/sweats
** chills/sweats
** non-productive cough
** non-productive cough
** nausea/vomiting
** [[nausea/vomiting]]
** diarrhea
** [[diarrhea]]
** abdominal pain
** [[abdominal pain]]
** chest pain
** [[chest pain]]
* Complications include pneumonia, granulomatous hepatitis (inflammation of the liver), myocarditis (inflammation of the heart tissue), and central nervous system complications.
* Complications include [[pneumonia]], granulomatous hepatitis (inflammation of the liver), [[myocarditis]] (inflammation of the heart tissue), and central nervous system complications.
* Endocarditis is the major form of chronic disease
* [[Endocarditis]] is the major form of chronic disease
* Infection in pregnancy is more likely to be asymptomatic, but often results in chronic Q fever and obstetrical complications
* Infection in pregnancy is more likely to be asymptomatic, but often results in chronic Q fever and obstetrical complications



Revision as of 21:08, 17 October 2014

Background

  • Described in 1937: occupational disease of abattoir workers (manage animals before and after slaughtering process) and dairy farmers
  • Caused by Coxiella burnetii
    • Obligate intracellular bacteria morphologically similar to Rickettsia
    • Reservoirs include cattle, goat, sheep, and ticks (Dermacentor andersoni)
  • CDC: category B biologic warfare agent due to its inhaled infectivity
  • Worldwide disease

Clinical Features

  • Symptoms usually develop within 2-3 weeks, although up to half of those infected may not show symptoms
  • Complications include pneumonia, granulomatous hepatitis (inflammation of the liver), myocarditis (inflammation of the heart tissue), and central nervous system complications.
  • Endocarditis is the major form of chronic disease
  • Infection in pregnancy is more likely to be asymptomatic, but often results in chronic Q fever and obstetrical complications

Differential Diagnosis

Fever in traveler

Workup

  • CBC, Complete Metabolic Panel – Liver enzymes usually elevated 2-10 times normal
  • Blood Cultures
  • CXR

Management

  • Doxycycline
    • Adults: 100 mg BID
    • Children < 45 kg: 2.2 mg/kg BID
  • Patients should be treated for at least 3 days after the fever subsides and until there is evidence of clinical improvement. Standard duration of treatment is 2-3 weeks.

Disposition

Most patients require admission for further workup

See Also

External Links

Sources