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Q fever

Definition


Disease: Q fever Q fever
Category: Infectious diseases

Disease Definition:

A specific type of bacteria carried by animals, commonly sheep, cattle and goats, causes the disease called Q fever. A person may become infected if they inhale barnyard dust particles contaminated by infected animals.

 

Although some people with Q fever may have flu-like symptoms or develop pneumonia or hepatitis, but most people have no initial symptoms. Chronic Q fever is a serious disease, which could affect the heart, liver, lungs and brain and last for three to four years. This condition is usually fatal and is caused by the acute form of Q fever.

 

With no treatment, acute fever usually clears up within a few weeks. The patient may be prescribed antibiotics in case he/she experiences symptoms. Specific antibiotic treatment, multiple follow-up tests and possibly surgery is needed for chronic Q fever.
 

Work Group:


Symptoms, Causes

Symptoms:

The signs and symptoms of Q fever could vary widely. Chronic Q fever usually affects the heart and other major organs, while acute Q fever may not cause any symptoms.

 

ACUTE Q FEVER:

Most people that are infected with acute Q fever do not show any signs or symptoms. However, in case someone develops symptoms, they may start occurring about two to three weeks after the person has been exposed to the bacteria. The signs and symptoms of the infection are similar to those of the flu, such as:

 

  • Chills
  • High fever (40 C or 104 F)
  • Chest pain
  • Fatigue
  • Vomiting
  • Nausea
  • Sweats
  • Severe headache
  • Severe muscle pain
  • Abdominal pain
  • Diarrhea
  • Cough, which could be dry or productive
  • Purplish rash
  • Sore throat

 

CHRONIC Q FEVER:

Q fever will be considered chronic in case a person has had it for more than 6 months. Even if the patient didn't show symptoms initially, chronic Q fever could develop anytime between 1 and 20 years after the initial acute Q fever.

 

Depending on how chronic Q fever manifests itself, its symptoms may vary. Some of the different ways in which chronic Q fever could affect a person may be:

Blood vessel infections:

A person may experience fatigue, weight loss, loss of appetite and fever in case the bacteria that cause Q fever infect the blood vessels.

Q fever endocariditis:

The heart's inner lining will be inflamed in case someone has endocarditis, leading to damage of the heart's valves. Chills, night sweats, shortness of breath, fatigue and prolonged fever are some of its signs and symptoms.

Other types of chronic Q fever:

In some rare cases, chronic Q fever may manifest itself as a chronic lung infection, chronic fatigue or bone infection (osteomyelitis). Each of these conditions has its own symptoms.
 

Causes:

Usually, coxiella burnetii bacteria infect animals, most commonly goats, cattle and sheep; however, it could also affect pets, such as rabbits, dogs, cats and birds. Through their feces, urine, milk and birth products, such as placenta and amniotic fluid, these mammals transmit the bacteria.

 

When they dry, the bacteria in these substances becomes part of the barnyard dust that floats in the air. So, when someone inhales contaminated barnyard dust, this infection could be transmitted through their lungs. In some rare cases, being bitten by an infected wood tick or drinking large amounts of unpasteurized mild could cause Q fever.

 

Someone’s risk of getting acute Q fever may be increased by some of these factors:

Occupation:

Meat processing, animal research, veterinary medicine and livestock farming are some of the occupations that put people at higher risk, because they’ll be exposed to animals and animal products.

History of acute Q fever:

People who've had Q fever are at risk of developing its chronic form. In case a person also has a weakened immune system, blood vessel abnormalities, chronic kidney disease or heart valve disease, the risk will be even greater.

Sex:

Symptomatic acute Q fever develops more commonly in men.

Location:

The bacteria could travel long distances accompanying dust particles in the air. Because of this, being near a farm or farming facility could put someone at a higher risk of developing Q fever.
 

Complications

Complications:

The brain, heart, lungs and liver could be affected by Q fever, causing some of these complications:

 

  • Pneumonia
  • Pregnancy complications, such as premature birth, stillbirth, miscarriage, intrauterine growth retardation and low birth weight
  • Inflammation of the membrane that surrounds the heart, a condition known as endocarditis.
  • Inflammation of the membrane that surrounds the brain and spinal cord, a condition known as meningitis
  • Acute respiratory distress, in which the person doesn’t get enough oxygen. This is a medical emergency.
     

Treatments:

Treatment for Q fever will depend on whether the patient is pregnant or not, and whether the condition is acute or chronic.

 

TREATMENT FOR ACUTE Q FEVER:

With no treatment, the mild or nonsymptomatic cases of acute Q fever usually get better within about two weeks. To prevent future complications, the patient may be recommended treatment even if they don't have any symptoms.

 

An antibiotic called doxycycline is the standard treatment for acute Q fever. The usual course of this medication is two weeks; however, the exact period of time the patient needs to take antibiotics will be determined by the severity of the infection. The antibiotics will be most effective when they are initiated within one week of symptoms' onset, because of this, people should get treatment as soon as they notice any symptoms.

 

The patient may be asked to return after six months for serologic testing, because acute Q fever could come back. He/she will be prescribed another round of antibiotics in case Q fever bacteria are found again.

 

TREATMENT FOR CHRONIC Q FEVER:

Usually, a combination of antibiotics is taken for at least 18 months to treat chronic Q fever. However, the patient may need to take the antibiotics for as long as four years if their condition is more advanced.

 

The patient may also need surgery to remove or graft the damaged heart valves or repair an aneurysm in case they have Q fever endocarditis. Despite the fact that treatments are available, complications could multiply quickly and become fatal. In case the infection returns, the patient will need to go back for follow-up tests for years, even after the chronic Q fever has been successfully treated.

 

TREATMENT OF Q FEVER DURING PREGNANCY:

The antibiotics that are usually prescribed for Q fever are not recommended during pregnancy. Because of this, treating Q fever during pregnancy could be quite a challenge. The patient should be sure to understand all of the treatment options and their risks in case she’s pregnant and has Q fever. Some women may choose to wait until after delivery to treat Q fever, but this method has its risks too. Acute Q fever could cause multiple complications for the baby, and pregnancy is a risk factor for developing chronic Q fever.
 

Prognosis:

Not available

Expert's opinion

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