Last reviewed: November 2017
Last updated: December  2016

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • abrupt onset of high fever
  • flu-like illness
  • severe headache
  • cough
  • inspiratory crackles, rhonchi, or wheezing
  • hepatomegaly

Other diagnostic factors

  • exanthemas
  • pleuritic chest pain
  • seizures
  • coma

Risk factors

  • exposure to infected animals
  • occupational exposure
  • travel or residency in endemic areas
  • male gender
  • age 30 to 70 years
  • immunosuppression
  • pre-existing cardiac disease
  • pre-existing vasculopathy
  • pregnancy

Diagnostic investigations

1st investigations to order

  • indirect immunofluorescence assay (IFA)
  • FBC
  • CRP
  • serum transaminases
  • serum alkaline phosphatase
  • total and conjugated bilirubin
  • activated partial thromboplastin time (aPTT)
  • IgG anticardiolipin (aCL) antibodies
Full details

Investigations to consider

  • CSF cell count and differential
  • CSF protein
  • CSF glucose
  • CXR
  • transthoracic echocardiography (TTE)
  • transoesophageal echocardiography (TEE)
  • liver ultrasound
  • abdominal CT scan or ultrasound
  • chest CT
  • brain CT
  • PCR
  • 18F-fluorodeoxyglucose (FDG) PET/CT imaging
  • lymph node biopsy
  • immunohistochemistry
  • fluorescence in situ hybridisation (FISH)
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Associate Professor

French National Referral Center for Q Fever

Institut Hospitalo-Universitaire Méditerranée Infection

Marseille

France

Disclosures

MM is the author of several references used in this monograph.

Professor

French National Referral Center for Q Fever

Institut Hospitalo-Universitaire Méditerranée Infection

Marseille

France

Disclosures

DR is the author of several references used in this monograph.

Dr Matthieu Million and Professor Didier Raoult would like to gratefully acknowledge Dr Nilmarie Guzman, a previous contributor to this monograph. NG declares that she has no competing interests.

Peer reviewers VIEW ALL

Consultant in Tropical and Travel Medicine

Hospitals for Tropical Diseases

Senior Lecturer

London School of Hygiene and Tropical Medicine

London

UK

Disclosures

RB has provided expert testimony on behalf of the Crown, to the courts in the UK, on Q fever.

Epidemiology Team

Rickettsial Zoonoses Branch

National Center for Zoonotic Vectorborne and Enteric Diseases

Centers for Disease Control and Prevention

Atlanta

GA

Disclosures

JM declares that she has no competing interests.

Clinical Microbiologist

National Influenza Center

Second Department of Microbiology

Aristotle University of Thessaloniki Medical School

Thessaloniki

Greece

Disclosures

DC declares that he has no competing interests.

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