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    Q fever

    Query fever

    Q fever is a bacterial infection that can affect the lungs, liver, heart, and other parts of the body.

    Causes

    Q fever is found around the world and is caused by the bacteria Coxiella burnetii. The bacteria infects sheep, goats, cattle, dogs, cats, birds, rodents, and ticks, as well as some other animals. Infected animals shed this bacteria in:

    • Birth products
    • Feces
    • Milk
    • Urine

    Humans usually get Q fever by breathing in contaminated droplets released by infected animals. Drinking raw milk has also caused infection in rare cases. People at highest risk for this infection are:

    • Farmers
    • Laboratory workers who work with Coxiella burnetii
    • Sheep and dairy workers
    • Veterinarians

    People at highest risk include those with heart valve problems or weakened immune systems.

    Symptoms

    It usually takes about 20 days after exposure to the bacteria for symptoms to occur. Most cases are mild, yet some severe cases have been reported.

    Common symptoms of acute Q fever may include:

    • Dry cough
    • Fever
    • Headache
    • Joint pain
    • Muscle pains

    Other symptoms may include:

    • Abdominal pain
    • Chest pain
    • Rash
    • Yellow skin (jaundice)

    Symptoms of chronic Q fever may include:

    • Chills
    • Fatigue
    • Night sweats
    • Prolonged fever
    • Shortness of breath

    Exams and Tests

    The health care provider will suspect Q fever in people who have been exposed to the Coxiella burnetii bacteria who develop:

    • Endocarditis
    • Flu-like symptoms
    • Hepatitis
    • Pneumonia

    Q fever is diagnosed with a blood antibody test (serology).

    Treatment

    The main treatment for Q fever is with antibiotics. For early-stage (acute) Q fever, doxycycline is the recommended antibiotic.

    If you have the infectionfor more than 6 months, it is calledchronic Q fever. Your doctor may prescribe both doxycycline and hydroxychloroquine. You may need to take antibiotics for several months or years.

    Outlook (Prognosis)

    The outlook for people who get treated in the early stages of Q fever is generally good.

    Chronic Q fever requires long-term treatment with antibiotics. Your health care provider should check you often to make sure the disease has not returned.

    Possible Complications

    • Bone infection (osteomyelitis)
    • Encephalitis (brain infection)
    • Infection of the heart valves (endocarditis)
    • Inflammation of the heart lining (pericarditis)
    • Inflammation of the heart muscle (myocarditis)
    • Liver infection (hepatitis)
    • Lung scarring (interstitial pulmonary fibrosis)
    • Meningitis
    • Pneumonia

    When to Contact a Medical Professional

    Notify your medical provider if you have symptoms of Q fever, especially if you believe you have been exposed to the bacteria. Although many different illnesses can cause similar symptoms, you may need to be evaluated for Q fever.

    Prevention

    People at risk (for example, farmers and veterinarians) should always:

    • Carefully dispose of animal products that may be infected
    • Disinfect any contaminated areas
    • Thoroughly wash your hands

    Pasteurizing milk can also help prevent Q fever.

    Prompt treatment can prevent early Q fever from becoming chronic.

    References

    Marrie TJ, Raoult D. Coxiella burnetii (Q fever). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 189.

    Raoult D. Rickettsial infections. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011: chap335.

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            Review Date: 10/6/2012

            Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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