Clinical features

• incubation period 1-3 weeks

• sudden onset fever, rigors and myalgia

• petechial rash (if persisting infection)

Persistent infection may cause pneumonia or endocarditis so patients with valvular disease are at risk of endocarditis. It is a rare cause of hepatitis. The acute illness may resolve spontaneously. Untreated chronic infection is usually fatal.

Diagnosis

• Serodiagnosis is by complement fixation tests.

Treatment

• for endocarditis: prolonged course doxycycline plus clindamycin or rifampicin

• Children: > 8 same antibiotics according to weight < 8 co-trimoxazole (instead of doxycycline)

Prevention

The disease can be prevented in abattoir workers by using Q fever vaccine.

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