Treatment and prevention of Q fever
- Didier Raoult, MD, PhD
Didier Raoult, MD, PhD
- Faculté de Médecine
- Aix Marseille Université
- Section Editors
- Daniel J Sexton, MD
Daniel J Sexton, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — Bacterial Infections
- Professor of Medicine
- Duke University Medical Center
- Morven S Edwards, MD
Morven S Edwards, MD
- Section Editor — Pediatric Infectious Diseases
- Professor of Pediatrics
- Baylor College of Medicine
Q fever is a widespread zoonotic infection caused by the pathogen, Coxiella burnetii . The designation Q fever (from Query) was made in 1935 following an outbreak of a febrile illness in slaughterhouse workers in Queensland, Australia. The disease is reportable in the United States, and its agent, C. burnetii, is a potential agent of bioterrorism . (See "Identifying and managing casualties of biological terrorism".)
The treatment and prevention of Q fever will be reviewed here. The microbiology, epidemiology, clinical manifestations, and diagnosis of Q fever, as well as Q fever endocarditis, are discussed separately. (See "Microbiology and epidemiology of Q fever" and "Clinical manifestations and diagnosis of Q fever" and "Q fever endocarditis".)
APPROACH TO TREATMENT
The approach to treatment for Q fever depends primarily upon the presence of acute or persistent localized disease . Acute and persistent infection can be distinguished through their clinical presentation and the results of serologic testing. A detailed discussion of the clinical manifestations and diagnosis of Q fever is found elsewhere. (See "Clinical manifestations and diagnosis of Q fever".)
In the past, the clinical manifestations of Q fever were typically divided into acute Q fever and chronic Q fever. However, patients were sometimes diagnosed with chronic Q fever without a clear clinical focus of disease. This has led to controversy over how to define chronic Q fever. Thus, rather than use the term "chronic Q fever" to describe a clinical condition, we prefer to describe the specific disease manifestations (table 1). (See "Clinical manifestations and diagnosis of Q fever", section on 'Clinical manifestations'.)
The treatment of choice for most patients is doxycycline. However, the duration of treatment and the need for additional agents and/or surgery are based upon the specific disease manifestation, as well as the patient’s underlying comorbidities. As examples:To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- APPROACH TO TREATMENT
- ACUTE Q FEVER
- Whom to treat
- Antimicrobial therapy
- - Non-pregnant adults
- - Children
- - Pregnant women
- - Patients with valvulopathy/cardiomyopathy
- Monitoring after treatment
- PERSISTENT LOCALIZED DISEASE
- Antimicrobial regimens for persistent disease
- Disease specific considerations
- - Endocarditis
- - Vascular infection
- - Osteomyelitis, arthritis
- Patient monitoring
- - Adverse effects of therapy
- - Serologic monitoring during treatment
- POST-Q FEVER FATIGUE SYNDROME
- Other measures
- SUMMARY AND RECOMMENDATIONS