Differentiation of Acute Q Fever from Other Infections in Patients Presenting to Hospitals, the Netherlands

Emerg Infect Dis. 2015 Aug;21(8):1348-56. doi: 10.3201/eid2108.140196.


Differentiating acute Q fever from infections caused by other pathogens is essential. We conducted a retrospective case-control study to evaluate differences in clinical signs, symptoms, and outcomes for 82 patients with acute Q fever and 52 control patients who had pneumonia, fever and lower respiratory tract symptoms, or fever and hepatitis, but had negative serologic results for Q fever. Patients with acute Q fever were younger and had higher C-reactive protein levels but lower leukocyte counts. However, a large overlap was found. In patients with an indication for prophylaxis, chronic Q fever did not develop after patients received prophylaxis but did develop in 50% of patients who did not receive prophylaxis. Differentiating acute Q fever from other respiratory infections, fever, or hepatitis is not possible without serologic testing or PCR. If risk factors for chronic Q fever are present, prophylactic treatment is advised.

Keywords: Coxiella burnetii; Q fever; acute Q fever; bacteria; case–control study; chronic Q fever; clinical practice; hospital; prophylactic treatment; prophylaxis; the Netherlands.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Female
  • Fever of Unknown Origin / diagnosis*
  • Fever of Unknown Origin / epidemiology
  • Hospitals / standards*
  • Hospitals / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Q Fever / diagnosis*
  • Q Fever / epidemiology
  • Q Fever / pathology
  • Risk Factors