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: | ||
*Incubation period is usually 2 to 3 weeks. | *[[Incubation period]] is usually 2 to 3 weeks. | ||
===Acute Q fever:=== | ===Acute Q fever:=== | ||
| Line 12: | Line 12: | ||
====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: | ||
*High grade | *[[Fever|High grade fever]]: Fever is usually accompanied by [[chills]] and sweats | ||
*Headaches: retrobulbar and associated with photophobia | *[[Headache|Headaches]]: retrobulbar and associated with [[photophobia]] | ||
*Arthralgias | *[[Arthralgia|Arthralgias]] | ||
====Pneumonia:==== | ====Pneumonia:==== | ||
Usually mild and accidentally discovered on X rays | Usually mild and accidentally discovered on [[X rays]] | ||
*If accompanied by cough, cough is dry and non productive. | *If accompanied by [[cough]], cough is dry and non productive. | ||
*Dyspnea | *[[Dyspnea]] | ||
*Pleuritic chest pain | *[[Pleuritic chest pain]] | ||
*Rarely progresses to ARDS which can be life threatening. | *Rarely progresses to [[Acute respiratory distress syndrome|acute respiratory distress syndrome (ARDS)]] which can be life threatening. | ||
====Hepatitis:==== | ====Hepatitis:==== | ||
*Abdominal right upper quadrant pain | *[[Right upper quadrant pain|Abdominal right upper quadrant pain]] | ||
*Jaundice | *[[Jaundice]] | ||
*GI symptoms as nausea, | *GI symptoms as [[nausea]], [[malaise]], [[vomiting]], [[diarrhea]] and [[bloating]]. | ||
====Rare acute Q fever symptoms:==== | ====Rare acute Q fever symptoms:==== | ||
====Pericarditis and myocarditis:==== | |||
*Myocarditis is rare but carries a bad prognosis | |||
*Chest pain | *[[Myocarditis]] is rare but carries a bad prognosis | ||
*Dyspnea | *[[Chest pain]] | ||
*Palpitation | *[[Dyspnea]] | ||
*[[Palpitation]] | |||
====Neurologic findings:==== | ====Neurologic findings:==== | ||
*Q fever can present with | *Q fever can present with [[meningoencephalitis]] | ||
*Headache | *[[Headache]] | ||
*Confusion | *[[Confusion]] | ||
*Seizures | *[[Seizures]] | ||
====Dermatologic findings:==== | ====Dermatologic findings:==== | ||
*Maculopapular rash | *[[Maculopapular rash]] | ||
*Diffuse punctate rash | *Diffuse punctate rash | ||
*Erythema nodosum | *[[Erythema nodosum]] | ||
====Q fever during pregnancy:==== | ====Q fever during pregnancy:==== | ||
*Most C. brutenii infection during pregnancy pass asymptomatic but in rare cases it can be complicated with: | *Most [[Coxiella burnetii|C. brutenii]] infection during pregnancy pass [[asymptomatic]] but in rare cases it can be complicated with: | ||
*Intrauterine growth retardation (IUGR) | *[[Intrauterine growth retardation|Intrauterine growth retardation (IUGR)]] | ||
*Intrauterine fetal death (IUFD) | *Intrauterine fetal death (IUFD) | ||
Infection during first trimester and placental infection are associated with increased risk of fetal compromise. | Infection during [[first trimester]] and [[placental]] infection are associated with increased risk of fetal compromise. | ||
===Chronic Q fever:=== | ===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. | 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:==== | ||
Endocarditis is the main manifestation of Q fever. | [[Endocarditis]] is the main manifestation of Q fever. | ||
*Characterized by being culture negative endocarditis | *Characterized by being [[Endocarditis|culture negative endocarditis]] | ||
*Patients who are predisposed to endocarditis include patients with valvular lesions, prosthetic valves and immunocompromised patients | *Patients who are predisposed to [[endocarditis]] include patients with [[Valvular heart disease|valvular lesions]], [[prosthetic valves]] and [[Immunocompromised|immunocompromised patients]] | ||
*Presents with: | *Presents with: | ||
**Low grade | **[[Low-grade fever|Low grade fever]] | ||
**Palpitations | **[[Palpitations]] | ||
**Dyspnea | **[[Dyspnea]] | ||
**Embolic manifestations | **[[Embolic|Embolic manifestations]] | ||
====Skeletal manifestations:==== | ====Skeletal manifestations:==== | ||
*Bone and joint infections are common manifestations of chronic Q fever. | *Bone and joint infections are common manifestations of chronic Q fever. | ||
*Presents with: | *Presents with: | ||
**Low grade fever | **[[Low-grade fever|Low grade fever]] | ||
**Bone and joint pain as in chronic osteomyelitis | **Bone and joint pain as in chronic [[osteomyelitis]] | ||
====Vascular lesions:==== | ====Vascular lesions:==== | ||
*Usually in previously affected vessel (e.g. aneurysm) | *Usually in previously affected vessel (e.g. [[aneurysm]]) | ||
====Cardiopulmonary affection:==== | ====Cardiopulmonary affection:==== | ||
*Chronic pleural or pericardial effusion and Interstitial pulmonary fibrosis present with dyspnea and fatigue. | *Chronic [[pleural]] or [[pericardial]] effusion and Interstitial [[pulmonary fibrosis]] present with [[dyspnea]] and [[fatigue]]. | ||
====Hepatic manifestations:==== | ====Hepatic manifestations:==== | ||
*Liver fibrosis or cirrhosis presents with symptoms of chronic hepatic decompensation (e.g jaundice, abdominal pain, fatigue, etc) | *[[Hepatic fibrosis|Liver fibrosis]] or [[cirrhosis]] presents with symptoms of chronic hepatic decompensation (e.g [[jaundice]], [[abdominal pain]], [[fatigue]], etc) | ||
====Chronic fatigue syndrome:==== | ====Chronic fatigue syndrome:==== | ||
Revision as of 17:36, 5 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:
- 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
- Headaches: retrobulbar and associated with photophobia
- Arthralgias
Pneumonia:
Usually mild and accidentally discovered on X rays
- If accompanied by cough, cough is dry and non productive.
- 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.