Q fever differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]

Overview

Q fever must be differentiated from other diseases that cause atypical pneumonia such as mycoplasma pneumonia and legionella pneumonia.

Differentiating Q fever from other diseases

Q fever must be differentiated from other diseases that cause atypical pneumonia such as mycoplasma pneumonia and legionella pneumonia.

Disease	Prominent clinical features	Lab findings	Chest X ray
Q fever
Mycoplasma pneumonia	Mycoplasma pneumonia can be asymptomatic Headache, nausea and malaise usually precede the onset of symptoms Cough which is intractable and nonproductive	Postitve coomb’s test Leukocytosis Thrombocytosis
Legionella pneumonia	Legionella pneumonia is characterized by cough that is slightly productive Constitutional symptoms such as chills, myalgia, arthralgia Gastrointestinal symptoms such as diarrhea, nausea and vomiting.	Labs are non specific for diagnosing legionella pneumonia Renal and hepatic dysfunction Thrombocytopenia and leucocytosis Hyponatraemia .
Chlamydia pneumonia	There are no specific clinical features for chlamydia pneumonia. Symptoms appear gradually. Chlamydia infection is usually associated with upper respiratory tract symptoms (pharyngitis, sinusitis, etc). It might be associated with extrapulmonary manifestaions as meningitis and guillain barre syndrome.	Chlamydia pneumonia is usually associated with normal WBC count. It's diagnosed with the presence of antichlamydial antibody (through complement fixation or direct immunofluoroscence) or direct antigen detection.

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