Chronic Q Fever Diagnosis | Medical Algorithm

A few patients with Q fever will develop a chronic febrile illness that can last for years.

General features:

(1) chronic febrile illness lasting > 6 months (FUO)

(2) routine cultures are negative

Clinical Syndrome	Predisposing Condition
culture negative endocarditis	valvular disease or prosthetic valve
culture negative infection of an aneurysm or vascular graft	aneurysm or vascular graft
osteomyelitis	immunocompromised
infectious arthritis	immunocompromised
pulmonary pseudotumor or pulmonary fibrosis	immunocompromised
chronic hepatitis	immunocompromised
chronic febrile illness during pregnancy	pregnancy
chronic pericarditis	immunocompromised
chronic fatigue syndrome	immunocompromised

Diagnosis can be made by:

(1) serologic testing

(2) PCR

(3) shell vial tissue culture

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Clinical Features of Chronic Q Fever