Q Fever: An Emerging Reality in Portugal

Area of Science:

• Infectious Diseases
• Zoonotic Diseases
• Public Health

Background:

• Q fever is a zoonosis caused by Coxiella burnetii, with increasing prevalence in Europe and endemic in Portugal.
• Transmission occurs via inhalation of aerosols or ingestion of contaminated dairy products from reservoirs like cattle, goats, and sheep.

Observation:

• Most Q fever cases are asymptomatic, but symptoms can include fever, atypical pneumonia, hepatitis, and cutaneous manifestations.
• Chronic or persistent Q fever can develop years after initial infection, necessitating long-term follow-up.
• The authors report a rare case of Coxiella burnetii pneumonia with cutaneous and hepatic involvement in a patient lacking typical risk factors.

Findings:

• Clinical presentation of Q fever is highly variable, often leading to delayed diagnosis.
• The disease requires systematic consideration, especially in patients with risk factors such as prostheses, immunosuppression, pregnancy, or specific epidemiological settings.
• This case underscores the diagnostic challenge of Q fever, emphasizing the need for a high index of suspicion.

Implications:

• Q fever should be included in the differential diagnosis for fever or atypical pneumonia, irrespective of known risk factors.
• Mandatory reporting of Q fever cases in Europe, particularly Portugal, is crucial for understanding its true public health impact.
• Early and accurate diagnosis is essential for managing Q fever and preventing potential long-term complications.