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Lyme Coinfection Series: Q Fever

By Beth Aust, RN, Holistic Health Coach

This is a continuation of our Lyme and coinfection series to help educate you.

“The path of light is the quest for knowledge.” - Lailah Gifty Akita, Pearls of Wisdom: Great mind

What is Q-Fever?

Q fever is a zoonosis, a disease that can be transmitted from animals to humans. Q Fever is an infectious fever caused by the bacterium Coxiella burnetii (Cb), which may be transmitted to humans from cattle, sheep, and other domesticated animals. People often get infected by infected animal feces, urine, milk, and birth products that contain Coxiella burnetii. Many cases happen from inhaling Cb containing dust, eating or drinking contaminated foods (like unpasteurized dairy products), blood transfusion, from a pregnant woman to her fetus, and through sexual transmission.

Q Fever is a disease that can be tick-borne, and therefore can be a coinfection with Lyme disease. Ticks that transmit Q fever include Amblyomma americanum (lone star tick) and Dermacentor andersoni (Rocky Mountain wood tick).

Two other conditions are commonly associated with acute Q fever to varying degrees – pneumonia and inflammation of the liver (hepatitis). Pneumonia is often mild but potentially can progress to cause acute respiratory distress syndrome (ARDS). Hepatitis may cause abnormal enlargement of the liver (hepatomegaly). More rarely, it can cause yellowing of the skin and the whites of the eyes (jaundice).

The acute form of Q fever usually starts approximately two to three weeks after exposure to the bacterium. Acute Q fever is usually characterized by flu-like symptoms such as high fevers, chills, muscle pain (myalgia), and headaches. In some cases, fevers do not occur. Additional nonspecific symptoms can potentially occur including a cough, chest pain, sore throat, skin rash, or gastrointestinal symptoms.

Chronic Q fever may occur months to years after acute disease or may occur without a previous history of acute Q fever. Most cases of chronic Q fever occur in individuals with predisposing conditions such as existing heart valve or blood vessel (vascular) abnormalities, or a compromised immune system.

Q fever has occurred more often in men than women, although researchers attribute this to the fact that more men work in occupations where exposure to C. burnetii bacterium is more likely to occur. Q fever can affect individuals of any age. Although children with Q fever are rarely reported, the diagnosis is probably often missed, and the actual incidence of Q fever in children is unknown. Some researchers have speculated that children develop symptoms less often than adults, and generally have milder disease than adults when symptoms do develop.

Q fever was first reported in the medical literature in 1937 by Edward Derrick who named the infection Query Fever.

What are the symptoms of Q Fever?

Symptoms include high fevers up to 105°F, severe headache, fatigue, myalgia, chills and/or sweats, cough, nausea, vomiting, diarrhea, abdominal pain, chest pain, and may include endocarditis, encephalitis, pneumonia, hepatitis, and splenomegaly.

Acute symptoms include hepatitis, pneumonia, or chronic endocarditis.

Diagnosis and Treatment

Most people with acute Q fever infection recover completely; however, some may experience serious illness with pneumonia, granulomatous hepatitis, myocarditis, or central nervous system complications.

Several aspects of Q fever make it challenging for healthcare providers to diagnose and treat. The symptoms vary from patient to patient and can be difficult to distinguish from other diseases. Diagnostic tests based on the detection of antibodies will frequently appear negative in the first 7-

15 days of illness.

Healthcare providers should also look at routine blood tests, such as a complete blood cell count or a chemistry panel. Clues such as a prolonged fever with low platelet count, normal leukocyte count, and elevated liver enzymes are suggestive of acute Q fever infection, but may not be present in all patients. After a suspected diagnosis is made based on clinical suspicion and treatment has begun, specialized laboratory testing should be used to confirm the diagnosis of Q fever.

Treatment must be based on clinical suspicion and should always begin before laboratory results return. If the patient is treated within the first 3 days of the disease, fever generally subsides within 72 hours. Severely ill patients may require longer periods before their fever resolves.

Find an expert:

If your feel you may have Q-fever or any tick-borne illness, and your health care provider is not knowledgeable about testing and treatment, contact Integrative Medicine of Central New York to schedule your initial consultation.

Dr. Puc has been trained in tick-borne disease and is knowledgeable and aware of current testing and treatment of Lyme disease and other coinfections such as Q Fever.

Contact the office for more information at (315) 741-5774.

This blog is part of our Lyme Disease and Coinfection series. Please be sure to check out the other blogs in our series, or subscribe to our newsletter for more information.


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