Q fever pneumonia refers to pulmonary infection with the organism Coxiella burnetii. It is sometimes classified as an atypical pneumonia. It can occur as either sporadic or outbreak cases.
The clinical picture is often dominated by fever, headaches and myalgias 5. A cough, if present, is often nonproductive and may even be absent despite the presence of the pneumonia.
Coxiella burnetii is an obligate intracellular parasite (zoonosis: small gram-negative coccobacillus) that lives in the phagolysosomes of the host cells. Common animal reservoirs include goats, cattle, sheep, cats, and occasionally dogs. The organism has a worldwide prevalence.
The diagnosis can be established serologically (i.e. total antibody or IgM).
The radiographic differentiation of Q fever pneumonia from other types of community-acquired pneumonias is not possible. Segmental or lobar opacification and occasional pleural effusions may be seen (all of which are non specific features on their own). Features can be slow to clear 4.
CT features are again individually non specific and often confirms airspace involvement, which can be lobar, segmental, patchy or a combination. Often more than one lobe may be involved.
Treatment and prognosis
Tetracycline is traditionally considered the drug of choice 1-2. Chloramphenicol, cotrimoxazole, and rifampicin may also be effective. In most cases the pneumonia results in an illness of mild-to-moderate severity although on occasion can be rapidly progressive and can result in respiratory failure 5.
History and etymology
It was first described by E H Derrick in 1937 1.
- 1. Gikas A, Kofteridis D, Bouros D et-al. Q fever pneumonia: appearance on chest radiographs. Radiology. 1999;210 (2): 339-43. doi:10.1148/radiology.210.2.r99fe20339 - Pubmed citation
- 2. Voloudaki AE, Kofteridis DP, Tritou IN et-al. Q fever pneumonia: CT findings. Radiology. 2000;215 (3): 880-3. doi:10.1148/radiology.215.3.r00jn21880 - Pubmed citation
- 3. Sobradillo V, Ansola P, Baranda F et-al. Q fever pneumonia: a review of 164 community-acquired cases in the Basque country. Eur. Respir. J. 1989;2 (3): 263-6. Pubmed citation
- 4. Pickworth FE, el-Soussi M, Wells IP et-al. The radiological appearances of 'Q' fever pneumonia. Clin Radiol. 1991;44 (3): 150-3. Pubmed citation
- 5. Marrie TJ. Coxiella burnetii (Q fever) pneumonia. Clin. Infect. Dis. 1996;21 Suppl 3: S253-64. Pubmed citation
- 6. Gordon JD, MacKeen AD, Marrie TJ et-al. The radiographic features of epidemic and sporadic Q fever pneumonia. J Can Assoc Radiol. 1985;35 (3): 293-6. Pubmed citation
- 7. Marrie TJ. Q fever pneumonia. Infect. Dis. Clin. North Am. 2010;24 (1): 27-41. doi:10.1016/j.idc.2009.10.004 - Pubmed citation
- 8. Marrie TJ. Coxiella burnetii pneumonia. Eur. Respir. J. 2003;21 (4): 713-9. Pubmed citation
- 9. Antony SJ, Schaffner W. Q fever pneumonia. Semin Respir Infect. 1997;12 (1): 2-6. Pubmed citation