Q fever: Difference between revisions

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


==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


==Differential Diagnosis==
==Differential Diagnosis==
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{{Lower respiratory zoonotic infections}}
{{Lower respiratory zoonotic infections}}


==Diagnosis==
==Evaluation==
* CBC, Complete Metabolic Panel – Liver enzymes usually elevated 2-10 times normal
*CBC, Complete Metabolic Panel – Liver enzymes usually elevated 2-10 times normal
* [[Blood cultures]]
*[[Blood cultures]]
* CXR
*[[CXR]]


==Management==
==Management==
* [[Doxycycline]]
*[[Doxycycline]]
** Adults: 100 mg BID
**Adults: 100mg BID
** Children < 45 kg: 2.2 mg/kg 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.
*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==
==Disposition==
Most patients require admission for further workup
*Most patients require admission for further workup


==See Also==
==See Also==
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==External Links==
==External Links==


==Sources==
==References==
<references/>
<references/>
*http://www.cdc.gov/qfever/
*http://www.ncbi.nlm.nih.gov/pubmed/16168313


[[Category:ID]]
[[Category:ID]]
* http://www.cdc.gov/qfever/
* Rosen’s Emergency Medicine 8th Edition
* www.uptodate.com
* http://www.ncbi.nlm.nih.gov/pubmed/16168313

Latest revision as of 12:30, 9 September 2016

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

Lower Respiratory Zoonotic Infections

Evaluation

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

Management

  • 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.

Disposition

  • Most patients require admission for further workup

See Also

External Links

References