Q Fever

  • Medical Author:

    Dr. Eddie Hooker is currently an Assistant Professor in the Department of Health Services Administration at Xavier University in Cincinnati, Ohio. He is also an Associate Clinical Professor in the Department of Emergency Medicine at the University of Louisville and at Wright State University. His areas of expertise include emergency medicine, epidemiology, health-services management, and public health.

  • Medical Author: Mary K. Bister, MD
  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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What are the signs and symptoms of Q fever?

About half of all people who are infected with the bacterium that causes Q fever have no symptoms at all. When the acute form of Q fever does cause symptoms, the symptoms can vary from person to person. Most often, people will suddenly develop flu-like symptoms, including fever (as high as 104 F-105 F), chills, muscle and joint aches, severe headache, nausea, vomiting, diarrhea, cough, rash, and chest or abdominal pain. These symptoms may last up to a few weeks. The chronic form of Q fever, which occurs in only about 5% of those people infected, most often causes an infection and inflammation of the valves inside the heart called endocarditis. The symptoms of endocarditis can include fever, night sweats, shortness of breath, muscle and joint aches, edema (swelling of the legs), and rash.

How do physicians diagnose Q fever?

The diagnosis of Q fever is difficult because the symptoms are very similar to many other illnesses and vary a lot from person to person. The diagnosis should be suspected in people who have risk factors or who live in an area where Q fever is common and present with the acute onset of symptoms. In order to confirm the diagnosis, a blood sample can be sent to test for antibodies to the bacterium. Because antibody levels can remain high for years after a person has been infected, elevated antibody levels do not necessarily mean that the patient is acutely infected. Samples should be sent again a few weeks later to look for changing antibody levels that confirm the diagnosis of acute infection. Samples can also be sent for PCR (polymerase chain reaction) testing, which can detect infection earlier than the antibody tests, but this is less often available. People who have tested positive for acute infection should have follow-up testing done for up to two years to watch for the development of chronic Q fever infection. In chronic Q fever infection, diagnosis can also be made by testing tissue from infected heart valves if they are surgically removed and replaced. Culturing Coxiella burnetii from serum or tissue is possible but requires special lab facilities because of the highly infectious nature of the organism. Once a diagnosis of Q fever is made, it must be reported to the state health department.

Medically Reviewed by a Doctor on 5/4/2015
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