Q fever

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

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)
- severe headache
- general malaise
- myalgias
- chills/sweats
- non-productive cough
- nausea/vomiting
- diarrhea
- abdominal pain
- chest pain
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

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

Doxycycline
- Adults: 100mg BID
- Children < 45 kg: 2.2mg/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.