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Alternative Names

Query fever Definition

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 affects 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 Chronic Q fever develops in people who have been infected for more than 6 months without effective treatment.

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.

Symptoms of acute Q fever may include:

Chest pain with breathing Clay-colored stools Cough Fever Headache Jaundice Muscle pains Rash (not common) Shortness of breath 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.

For chronic Q fever, a combination of doxycycline and hydroxychloroquine is often used. You may need to take antibiotics for several months.

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

Cirrhosis, hepatitis, and other liver problems Encephalitis Infection of the heart valves (endocarditis) Inflammation of the heart lining (pericarditis) Inflammation of the heart muscle (myocarditis) 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

Baoult D. Rickettsioses. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 348.

Update Date: 9/28/2008

Updated by: Jatin M. Vyas, MD, PhD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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