Sandbox: old q
History and Symptoms
- Incubation period is usually 2 to 3 weeks.
- The most common manifestation is flu-like symptoms with abrupt onset of:
- During the course, the disease can progress to an atypical pneumonia, which can result in a life threatening acute respiratory distress syndrome (ARDS), whereby such symptoms usually occur during the first 4-5 days of infection.
- Less often the Q fever causes (granulomatous) hepatitis which becomes symptomatic with:
- The chronic form of the Q fever is virtually identical with endocarditis, which can occur after months or decades following the infection. It is usually deadly if untreated. However, with appropriate treatment this lethality is around 10%
Only about one-half of all people infected with C. burnetii show signs of clinical illness. Most acute cases of Q fever begin with sudden onset of one or more of the following: high fevers (up to 104-105° F), severe headache, general malaise, myalgia, confusion, sore throat, chills, sweats, non-productive cough, nausea, vomiting, diarrhea, abdominal pain, and chest pain. Fever usually lasts for 1 to 2 weeks. Weight loss can occur and persist for some time. Thirty to fifty percent of patients with a symptomatic infection will develop pneumonia. Additionally, a majority of patients have abnormal results on liver function tests and some will develop hepatitis. In general, most patients will recover to good health within several months without any treatment. Only 1%-2% of people with acute Q fever die of the disease.
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 infectioQ-fever can cause endocarditis (infection of the heart valves) which may require transoesophageal echocardiography to diagnose. Most patients who develop chronic Q fever have pre-existing valvular heart disease or have a history of vascular graft. Transplant recipients, patients with cancer, and those with chronic kidney disease are also at risk of developing chronic Q fever. As many as 65% of persons with chronic Q fever may die of the disease. Q-fever hepatitis manifests as an elevation of ALT and AST, but a definitive diagnosis is only possible on liver biopsy which shows the characteristic fibrin ring granulomas.[1]
The incubation period for Q fever varies depending on the number of organisms that initially infect the patient. Infection with greater numbers of organisms will result in shorter incubation periods. Most patients become ill within 2-3 weeks after exposure. Those who recover fully from infection may possess lifelong immunity against re-infection.
Common symptoms include:
- Dry cough (nonproductive)
- Fever
- Headache
- Joint pain (arthralgia)
- Muscle pains
Other symptoms that may develop include:
- Abdominal pain
- Chest pain
- Jaundice
- Rash
Complications
Rarely, a heart infection results that can lead to severe symptoms or even death if untreated. Other complications can include:
- ↑ van de Veerdonk FL, Schneeberger PM. (2006). "Patient with fever and diarrea". Clin Infect Dis. 42: 1051&ndash, 2.