ENLmedical.com: Conditions And Concerns: Medical Encyclopedia: Q fever (late)

Q fever (late)

Causes and Risks:
Q fever is caused by the organism Coxiella burnetii. This organism primarily lives in domestic animals (cattle, sheep, and goats), cats, wild animals, and ticks .

Hepatitis or pneumonia may develop in early disease. Late Q fever involves a relapse of the initial infection, or the infection may become chronic (persistent). Inflammation of the aortic heart valve may occur, causing endocarditis as a rare complication.

Prevention:
Q fever should be treated when it has been diagnosed.

Symptoms:
Initial symptoms may reappear or may persist:

fever
headache
muscle pains
joint pain ( arthralgia )
dry cough (non-productive)

Other symptoms that may develop include:

Signs and Tests:
Physical examination may reveal an enlarged liver and spleen. Listening to the chest with a stethoscope ( auscultation ) may reveal a heart murmur.

Tests:

Serology tests show the presence of antibodies to Coxiella. This includes complement fixation, immunofluorescence antibody tests, or ELISA tests.
A chest X-ray often shows pneumonia , atelectasis , or other changes.
An ECG may be performed to determine if the disease has affected the heart.

This disease may also alter the results of a febrile/cold agglutinins test.

Treatment:
Treatment with antibiotics can suppress the symptoms and shorten the length of the illness. Antibiotics that are commonly used include any of the tetracycline derivatives, doxycycline, rifampin, and trimethoprim-sulfamethoxazole. Chloramphenicol may also used. Antibiotic therapy for endocarditis may need to be continued for years.

Note: oral tetracycline is usually not prescribed for children until after all the permanent teeth have erupted; it can permanently discolor teeth that are still forming.

Prognosis:
Most infections do not progress to the late disease. However, complications can be serious or even life-threatening.

Complications:

Call Your Healthcare Provider:
Call your health care provider if you have had Q fever and symptoms persist or reappear.

Call your health care provider if you have late Q fever and any new symptoms develop, including jaundice , abdominal pain , confusion , or persistent fever .