Q fever Flashcards
Q fever (agent)
coxiella burnetti
agent - details
intracellular prokaryocyte
Q fever (source and time)
infected cattle, cows, sheep and goats
April to may
Q fever (transmission)
inhalation of dust from animal feces, when animals give birth these released in the air (high concentration in placenta), consumption of raw milk products from animals
Q fever (risky people)
Vets, farmers, people working or living close to farms, M > F( female hormones have protective effect)
Q fever (how they infect)
Spores in air -> incubate for 20 days -> multiply in acidic vacuoles in macrophages -> exhibit antigenic variation -> phase I (infect animals), phase II (non infectious as they LPS capsule is altered)
*phase II Ab develop before phase I Ab and hence can be detected earlier)
Q fever (clinical)
60% asymptomatic
Fever, extreme fatigue, photophobia, severe headache, chills, sweats, myalgia, atypical interstitial pneumonia (mild, non-productive cough, dyspnea, pleuritic chest pain)
Systemic -> hepatitis, CNS, endocarditis
-> Post Q fever fatigue syndrome
Hepatic granulomas (donut like) and hepatomegaly is possible
Associate with APAS (what is this???)
Q fever (chronic???)
Patients with previous valvular heart disease (vegetations) and almost always is associated with endocarditis (culture neg endocarditis), low grade fevers, CV infection, hepatic dysfunction(cirrhosis -> amyloidosis and increased risk of lymphoma and ischemic complications), bone/joint infection
Q fever (diagnosis)
Labs (high ALT AST ALP WBC PLTs), ACD, high CPK ESR, AMA + ASMA + APA +, blood culture -
serology, PCR
Serology and IFA - Antiphase II >1:200 IgG and >1:50 IgM
Clinical cure : Anti phase II <1:200 IgG
Q fever (post Q fever fatigue syndrome)
Ongoing sx + impaired short term memory
Q fever (treament)
Acute: doxycyline 100mg 2x for 14 days
Chronic: doxycyline or FQs 3-4 years
Pregnant : TMP/SMX
