Q Fever, an Under-Recognized and Under-Diagnosed Disease: A Case Report

Q fever is an illness following infection by the organism Coxiella burnetii. It is usually associated with an asymptomatic infection in animals which lends a hand in how it is easily transmitted to other hosts such as humans who encounter the bodily fluids of infected animals. Its presentation reflects an acute viral illness with malaise, fever/chills, and vomiting seen in acute cases while endocarditis and other severe sequelae can be seen in chronic infections. Here we have a 55-year-old male who presented for further evaluation of his muscular pains following a motor vehicle accident. His physical exam was benign except for tenderness in his left shoulder and cervical musculature. In interviewing the patient, he reported having fevers/chills, night sweats, and episodes of vomiting for several weeks which led him to seek further medical care. After many tests including a complete blood count (CBC), complete metabolic panel (CMP), blood cultures, and stool/ova testing came back normal, a Q fever phase 1 and 2 titer was performed and confirmed the suspected diagnosis of Q fever due to a lack of his symptoms being explained by another etiology. Although his initial symptoms were consistent with acute Q fever, the continuation of his symptoms suggests the possibility of Q fever fatigue syndrome. This case report highlights the under-recognized, uncommon zoonotic infection that plagues those working in the animal industry while also exploring the various presentations of it.