Q fever differential diagnosis: Difference between revisions
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|Q fever | |Q fever | ||
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* Q fever is characterized by abrupt onset of fever, myalgia, headache and other constitutional symptoms. | * Q fever is characterized by abrupt onset of [[fever]], [[myalgia]], [[headache]] and other constitutional symptoms. | ||
* Cough is the most prominent respiratory symptom and it is usually dry.<ref name="pmid23422417">{{cite journal |vauthors=Irfan M, Farooqi J, Hasan R |title=Community-acquired pneumonia |journal=Curr Opin Pulm Med |volume=19 |issue=3 |pages=198–208 |year=2013 |pmid=23422417 |doi=10.1097/MCP.0b013e32835f1d12 |url=}}</ref> | * [[Cough]] is the most prominent respiratory symptom and it is usually dry.<ref name="pmid23422417">{{cite journal |vauthors=Irfan M, Farooqi J, Hasan R |title=Community-acquired pneumonia |journal=Curr Opin Pulm Med |volume=19 |issue=3 |pages=198–208 |year=2013 |pmid=23422417 |doi=10.1097/MCP.0b013e32835f1d12 |url=}}</ref> | ||
* Cough is associated with dyspnea and pleuritic chest pain. | * [[Cough]] is associated with [[dyspnea]] and [[pleuritic chest pain]]. | ||
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* Antibody detection using Indirect immunofluorescence (IIF) is the preferred method for diagnosis. | * [[Antibody]] detection using [[Immunofluorescence|Indirect immunofluorescence]] (IIF) is the preferred method for diagnosis. | ||
* PCR can be used if IIF is negative or very early once disease is suspected. | * [[Polymerase chain reaction|PCR]] can be used if IIF is negative or very early once disease is suspected. | ||
* C. brutenii | * C. brutenii does not grow on ordinary blood cultures but can be cultivated on special media as embryonated eggs or cell culture. | ||
* 2-3 fold increase in AST and ALT is seen in most of the patients. | * 2-3 fold increase in [[Aspartate transaminase|AST]] and [[ALT]] is seen in most of the patients. | ||
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[[Image:Q fever.gif|center|300px|thumb|Q fever pneumonia - - Case courtesy of Royal Melbourne Hospital Respiratory, Radiopaedia.org, rID 21993 ]] | [[Image:Q fever.gif|center|300px|thumb|Q fever pneumonia - - Case courtesy of Royal Melbourne Hospital Respiratory, Radiopaedia.org, rID 21993 ]] | ||
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|Mycoplasma pneumonia | |Mycoplasma pneumonia | ||
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* Mycoplasma pneumonia can be asymptomatic | * [[Mycoplasma pneumonia]] can be asymptomatic | ||
* Headache, nausea and malaise usually precede the onset of symptoms <ref name="pmid23422417">{{cite journal |vauthors=Irfan M, Farooqi J, Hasan R |title=Community-acquired pneumonia |journal=Curr Opin Pulm Med |volume=19 |issue=3 |pages=198–208 |year=2013 |pmid=23422417 |doi=10.1097/MCP.0b013e32835f1d12 |url=}}</ref> | * [[Headache]], [[Nausea and vomiting|nausea]] and [[malaise]] usually precede the onset of symptoms <ref name="pmid23422417">{{cite journal |vauthors=Irfan M, Farooqi J, Hasan R |title=Community-acquired pneumonia |journal=Curr Opin Pulm Med |volume=19 |issue=3 |pages=198–208 |year=2013 |pmid=23422417 |doi=10.1097/MCP.0b013e32835f1d12 |url=}}</ref> | ||
* Cough which is intractable and nonproductive | * [[Cough]] which is intractable and nonproductive | ||
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* Postitve | * Postitve [[Coombs test|Coomb’s test]] | ||
* Leukocytosis | * [[Leukocytosis]] | ||
* Thrombocytosis | * [[Thrombocytosis]] | ||
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[[Image:Atypical-pneumonia-mycoplasma - Case courtesy of Dr Alborz Jahangiri, Radiopaedia.org, rID 45781.jpg|center|300px|thumb|Mycoplasma pneumonia - Case courtesy of Dr Alborz Jahangiri, Radiopaedia.org, rID 45781]] | [[Image:Atypical-pneumonia-mycoplasma - Case courtesy of Dr Alborz Jahangiri, Radiopaedia.org, rID 45781.jpg|center|300px|thumb|Mycoplasma pneumonia - Case courtesy of Dr Alborz Jahangiri, Radiopaedia.org, rID 45781]] | ||
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| | |[[Legionellosis]] | ||
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* Legionella pneumonia is characterized by cough that is slightly productive<ref name="pmid23422417">{{cite journal |vauthors=Irfan M, Farooqi J, Hasan R |title=Community-acquired pneumonia |journal=Curr Opin Pulm Med |volume=19 |issue=3 |pages=198–208 |year=2013 |pmid=23422417 |doi=10.1097/MCP.0b013e32835f1d12 |url=}}</ref> | * [[Legionella pneumophila|Legionella pneumonia]] is characterized by cough that is slightly productive<ref name="pmid23422417">{{cite journal |vauthors=Irfan M, Farooqi J, Hasan R |title=Community-acquired pneumonia |journal=Curr Opin Pulm Med |volume=19 |issue=3 |pages=198–208 |year=2013 |pmid=23422417 |doi=10.1097/MCP.0b013e32835f1d12 |url=}}</ref> | ||
* Constitutional symptoms such as chills, myalgia, arthralgia | * Constitutional symptoms such as chills, myalgia, arthralgia | ||
* Gastrointestinal symptoms such as diarrhea, nausea and vomiting. | * Gastrointestinal symptoms such as diarrhea, nausea and vomiting. | ||
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* Labs are non specific for diagnosing legionella pneumonia | * Labs are non specific for diagnosing legionella pneumonia | ||
* Renal and hepatic dysfunction | * [[Renal dysfunction|Renal]] and [[hepatic dysfunction]] | ||
* Thrombocytopenia and | * [[Thrombocytopenia]] and [[leukocytosis]] | ||
* | * [[Hyponatremia]] | ||
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[[Image:Legionella-pneumonia - Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID 31816.jpg|center|300px|thumb|Legionella pneumonia - Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID 31816 ]] | [[Image:Legionella-pneumonia - Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID 31816.jpg|center|300px|thumb|Legionella pneumonia - Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID 31816 ]] | ||
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|Chlamydia pneumonia | |[[Chlamydia pneumonia]] | ||
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* There are no specific clinical features for chlamydia pneumonia. | * There are no specific clinical features for chlamydia pneumonia. | ||
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* It might be associated with extrapulmonary manifestaions as meningitis and guillain barre syndrome.<ref name="pmid23422417">{{cite journal |vauthors=Irfan M, Farooqi J, Hasan R |title=Community-acquired pneumonia |journal=Curr Opin Pulm Med |volume=19 |issue=3 |pages=198–208 |year=2013 |pmid=23422417 |doi=10.1097/MCP.0b013e32835f1d12 |url=}}</ref> | * It might be associated with extrapulmonary manifestaions as meningitis and guillain barre syndrome.<ref name="pmid23422417">{{cite journal |vauthors=Irfan M, Farooqi J, Hasan R |title=Community-acquired pneumonia |journal=Curr Opin Pulm Med |volume=19 |issue=3 |pages=198–208 |year=2013 |pmid=23422417 |doi=10.1097/MCP.0b013e32835f1d12 |url=}}</ref> | ||
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* Chlamydia pneumonia is usually associated with normal WBC count. | * [[Chlamydia pneumonia]] is usually associated with normal [[WBC|WBC count.]] | ||
* It's diagnosed with the presence of antichlamydial antibody (through complement fixation or direct immunofluoroscence) or direct antigen detection. | * It's diagnosed with the presence of antichlamydial antibody (through complement fixation or direct immunofluoroscence) or direct antigen detection. | ||
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Revision as of 22:24, 12 July 2017
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Q fever Microchapters |
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Q fever differential diagnosis On the Web |
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Risk calculators and risk factors for Q fever differential diagnosis |
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 |
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| Q fever |
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| Mycoplasma pneumonia |
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| Legionellosis |
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| Chlamydia pneumonia |
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