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Infecção por Coxiella burnetii

Last reviewed: 9 Aug 2025
Last updated: 25 Apr 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • início abrupto de febre alta
  • doença semelhante à gripe
  • cefaleia intensa
  • tosse
  • estertores inspiratórios, roncos ou sibilância
  • hepatomegalia
Full details

Other diagnostic factors

  • exantemas
  • dor torácica pleurítica
  • convulsões
  • coma
  • fadiga crônica
  • sinais de endocardite ou infecção vascular (infecção focalizada persistente)
  • outros sinais de infecção focalizada persistente
  • outros sinais de infecção aguda
Full details

Risk factors

  • exposição a animais infectados
  • exposição ocupacional
  • viagem ou residência em áreas endêmicas
  • sexo masculino
  • idade entre 30 a 70 anos
  • imunossupressão
  • doença cardíaca preexistente
  • vasculopatia preexistente
  • gestação
Full details

Diagnostic investigations

1st investigations to order

  • ensaio de imunofluorescência indireta
  • reação em cadeia da polimerase
  • Hemograma completo
  • proteína C-reativa
  • TFHs
  • tempo de tromboplastina parcial ativada (TTPa)
  • anticorpos anticardiolipina (aCL) da IgG
Full details

Investigations to consider

  • contagem celular do líquido cefalorraquidiano e diferencial
  • proteína do líquido cefalorraquidiano
  • glicose do líquido cefalorraquidiano
  • radiografia torácica
  • ecocardiografia transtorácica (ETT)
  • ecocardiografia transesofágica (ETE)
  • ultrassonografia do fígado
  • TC (tomografia computadorizada) ou ultrassonografia abdominal
  • tomografia computadorizada (TC) do tórax
  • tomografia computadorizada (TC) cerebral
  • tomografia por emissão de pósitrons (PET)/tomografia computadorizada (TC) com 18-fluordesoxiglucose (FDG)
  • biópsia de linfonodos
  • imuno-histoquímica
  • hibridização in situ fluorescente (FISH)
Full details

Treatment algorithm

ACUTE

infecção aguda, não gestante, sem imunodeficiência grave: com baixo risco de infecção focalizada persistente

infecção aguda, não gestante, sem imunodeficiência grave: com alto risco de infecção focalizada persistente

infecção aguda, não gestante, com imunodeficiência grave

infecção aguda, gestante

ONGOING

infecção focalizada persistente suspeita ou confirmada, sem imunodeficiência grave

infecção focalizada persistente suspeita ou confirmada, com imunodeficiência grave

Contributors

Authors

Stephen Gluckman, MD

Professor of Medicine

Medical Director, Penn Global Medicine

Hospital of the University of Pennsylvania

Penn International Medicine and Immunization Clinic; Penn Center for Primary Care

Philadelphia

PA

Disclosures

SG declares that he has no competing interests.

Acknowledgements

Professor Stephen Gluckman would like to gratefully acknowledge Dr Joshua Hartzell, Dr Matthieu Million, Professor Didier Raoult, and Dr Nilmarie Guzman, previous contributors to this topic.

Disclosures

MM and DR are authors of several references cited in this topic. JH and NG declare that they have no competing interests.

Peer reviewers

Jennifer McQuiston, DVM, MS, DACVPM

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.

Dimitrios Chatzidimitriou, MD, PhD

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Anderson A, Bijlmer H, Fournier PE, et al. Diagnosis and management of Q fever - United States, 2013: recommendations from CDC and the Q fever working group. MMWR Recomm Rep. 2013 Mar 29;62(RR-03):1-23.Full text  Abstract

National Association of State Public Health Veterinarians, National Assembly of State Animal Health Officials​. Prevention and control of coxiella burnetii infection among humans and animals: guidance for a coordinated public health and animal health response, 2013. 2013 [internet publication].Full text

Centers for Disease Control and Prevention. Q fever: information for healthcare providers​. Jan 2019 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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