Q fever history and symptoms: Difference between revisions
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==History and symptoms== | ==History and symptoms== | ||
*Q fever can present with a wide variety of symptoms related to multiple organs involved. Q fever can be classified into acute and chronic based on the onset of symptoms | *Q fever can present with a wide variety of symptoms related to multiple organs involved. Q fever can be classified into acute and chronic based on the onset of symptoms.<ref name="pmid88923">{{cite journal |vauthors=Ishikawa H, Maeda H, Takamatsu H, Saito Y |title=Systemic hyalinosis (juvenile hyaline fibromatosis). Ultrastructure of the hyaline with particular reference to the cross-banded structure |journal=Arch. Dermatol. Res. |volume=265 |issue=2 |pages=195–206 |year=1979 |pmid=88923 |doi= |url=}}</ref><ref name="pmid1489455">{{cite journal |vauthors=Choyce DP |title=Anterior chamber lens exchange |journal=J Cataract Refract Surg |volume=18 |issue=5 |pages=537 |year=1992 |pmid=1489455 |doi= |url=}}</ref> | ||
*[[Incubation period]] is usually 2 to 3 weeks. | *[[Incubation period]] is usually 2 to 3 weeks. | ||
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====Flu like symptoms:==== | ====Flu like symptoms:==== | ||
The most common manifestation is flu-like symptoms with abrupt onset of: | The most common manifestation is flu-like symptoms with abrupt onset of: | ||
*[[Fever|High grade fever]]: Fever is usually accompanied by [[chills]] and sweats | *[[Fever|High grade fever]]: Fever is usually accompanied by [[chills]] and sweats<ref name="pmid18452690">{{cite journal |vauthors=Hartzell JD, Wood-Morris RN, Martinez LJ, Trotta RF |title=Q fever: epidemiology, diagnosis, and treatment |journal=Mayo Clin. Proc. |volume=83 |issue=5 |pages=574–9 |year=2008 |pmid=18452690 |doi=10.4065/83.5.574 |url=}}</ref> | ||
*[[Headache|Headaches]]: retrobulbar and associated with [[photophobia]] | *[[Headache|Headaches]]: retrobulbar and associated with [[photophobia]] | ||
*[[Arthralgia|Arthralgias]] | *[[Arthralgia|Arthralgias]] | ||
| Line 18: | Line 18: | ||
====Pneumonia:==== | ====Pneumonia:==== | ||
Usually mild and accidentally discovered on [[X rays]] | Usually mild and accidentally discovered on [[X rays]] | ||
*If accompanied by [[a cough]], cough is dry and nonproductive. | *If accompanied by [[a cough]], cough is dry and nonproductive.<ref name="pmid2731605">{{cite journal |vauthors=Sobradillo V, Ansola P, Baranda F, Corral C |title=Q fever pneumonia: a review of 164 community-acquired cases in the Basque country |journal=Eur. Respir. J. |volume=2 |issue=3 |pages=263–6 |year=1989 |pmid=2731605 |doi= |url=}}</ref> | ||
*[[Dyspnea]] | *[[Dyspnea]] | ||
*[[Pleuritic chest pain]] | *[[Pleuritic chest pain]] | ||
Revision as of 19:03, 8 June 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
History and symptoms
- Q fever can present with a wide variety of symptoms related to multiple organs involved. Q fever can be classified into acute and chronic based on the onset of symptoms.[1][2]
- Incubation period is usually 2 to 3 weeks.
Acute Q fever:
Flu like symptoms:
The most common manifestation is flu-like symptoms with abrupt onset of:
- High grade fever: Fever is usually accompanied by chills and sweats[3]
- Headaches: retrobulbar and associated with photophobia
- Arthralgias
Pneumonia:
Usually mild and accidentally discovered on X rays
- If accompanied by a cough, cough is dry and nonproductive.[4]
- Dyspnea
- Pleuritic chest pain
- Rarely progresses to acute respiratory distress syndrome (ARDS) which can be life threatening.
Hepatitis:
- Abdominal right upper quadrant pain
- Jaundice
- GI symptoms as nausea, malaise, vomiting, diarrhea and bloating.
Rare acute Q fever symptoms:
Pericarditis and myocarditis:
- Myocarditis is rare but carries a bad prognosis
- Chest pain
- Dyspnea
- Palpitation
Neurologic findings:
- Q fever can present with meningoencephalitis
- Headache
- Confusion
- Seizures
Dermatologic findings:
- Maculopapular rash
- Diffuse punctate rash
- Erythema nodosum
Q fever during pregnancy:
- Most C. brutenii infection during pregnancy pass asymptomatic but in rare cases it can be complicated with:
- Intrauterine growth retardation (IUGR)
- Intrauterine fetal death (IUFD)
Infection during first trimester and placental infection are associated with increased risk of fetal compromise.
Chronic Q fever:
Chronic Q fever, characterized by infection that persists for more than 6 months is uncommon but is a much more serious disease. Patients who have had acute Q fever may develop the chronic form as soon as 1 year or as long as 20 years after initial infection.
Endocarditis:
Endocarditis is the main manifestation of Q fever.
- Characterized by being culture negative endocarditis
- Patients who are predisposed to endocarditis include patients with valvular lesions, prosthetic valves and immunocompromised patients
- Presents with:
Skeletal manifestations:
- Bone and joint infections are common manifestations of chronic Q fever.
- Presents with:
- Low grade fever
- Bone and joint pain as in chronic osteomyelitis
Vascular lesions:
- Usually in previously affected vessel (e.g. aneurysm)
Cardiopulmonary affection:
- Chronic pleural or pericardial effusion and Interstitial pulmonary fibrosis present with dyspnea and fatigue.
Hepatic manifestations:
- Liver fibrosis or cirrhosis presents with symptoms of chronic hepatic decompensation (e.g jaundice, abdominal pain, fatigue, etc)
Chronic fatigue syndrome:
- Presents in up to 10% of chronic Q fever patients.
References
- ↑ Ishikawa H, Maeda H, Takamatsu H, Saito Y (1979). "Systemic hyalinosis (juvenile hyaline fibromatosis). Ultrastructure of the hyaline with particular reference to the cross-banded structure". Arch. Dermatol. Res. 265 (2): 195–206. PMID 88923.
- ↑ Choyce DP (1992). "Anterior chamber lens exchange". J Cataract Refract Surg. 18 (5): 537. PMID 1489455.
- ↑ Hartzell JD, Wood-Morris RN, Martinez LJ, Trotta RF (2008). "Q fever: epidemiology, diagnosis, and treatment". Mayo Clin. Proc. 83 (5): 574–9. doi:10.4065/83.5.574. PMID 18452690.
- ↑ Sobradillo V, Ansola P, Baranda F, Corral C (1989). "Q fever pneumonia: a review of 164 community-acquired cases in the Basque country". Eur. Respir. J. 2 (3): 263–6. PMID 2731605.