Q fever history and symptoms: Difference between revisions
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Latest revision as of 23:55, 29 July 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]
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Overview
Acute Q fever presents with flu-like symptoms, pneumonia, and hepatitis. Chronic Q fever almost always presents with endocarditis and sometimes has musculoskeletal and vascular manifestations.
History and symptoms
- Q fever can present with a wide variety of symptoms based on the multiple organs involved. Q fever can be classified as acute or chronic based on the onset of symptoms.[1][2]
- The 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, the 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 including nausea, malaise, vomiting, diarrhea, and bloating.
Rare acute Q fever symptoms
Pericarditis and myocarditis
- Myocarditis is rare but is associated with a bad prognosis[5]
- Chest pain
- Dyspnea
- Palpitation
Neurologic findings
- Q fever can present with meningoencephalitis
- Headache
- Confusion
- Seizures
Dermatologic findings
Q fever during pregnancy
Most C. brutenii infections during pregnancy are asymptomatic but in rare cases, can cause:
- Intrauterine growth retardation (IUGR)[6]
- Intrauterine fetal death (IUFD)
- Abortion
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.[2]
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 effects
- 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 and fatigue)
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.
- ↑ 2.0 2.1 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.
- ↑ Derrick EH (1983). ""Q" fever, a new fever entity: clinical features, diagnosis and laboratory investigation". Rev. Infect. Dis. 5 (4): 790–800. PMID 6622891.
- ↑ Stein A, Raoult D (1998). "Q fever during pregnancy: a public health problem in southern France". Clin. Infect. Dis. 27 (3): 592–6. PMID 9770161.