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Treatment and prevention of Q fever

Didier Raoult, MD, PhD
Section Editors
Daniel J Sexton, MD
Morven S Edwards, MD
Deputy Editor
Jennifer Mitty, MD, MPH


Q fever is a widespread zoonotic infection caused by the pathogen, Coxiella burnetii [1]. 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 [2]. (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".)


The approach to treatment for Q fever depends primarily upon the presence of acute or persistent localized disease [3]. 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:

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Literature review current through: Nov 2017. | This topic last updated: Apr 28, 2016.
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