Q Fever in the Differential Diagnosis of COVID 19 Infection

Coxiella burnetii is an intracellular, Gram-negative bacteria and is the causative agent of Q fever, a zoonosis first described in Australia in 1937. It can cause endemics around the world. People usually get the disease by inhaling the contaminated aerosol produced by infected livestock. Contaminated milk, intradermal inoculation, sexual contact, blood transfusion, and transplacental route may also occur. The infective dose for humans is 1-10 bacteria. It is resistant to environmental conditions and can remain alive in animal wastes such as dust and fertilizer. Acute infection is typically asymptomatic or may manifest as a febrile flu-like illness, pneumonia, hepatitis, and central nervous system (CNS) infection. Q fever outbreaks are often caused by occupational exposure that includes shepherds, animal keepers, veterinarians, slaughterhouses or dairy workers, and laboratory personnel working with C. burnetii. During the course of the disease that cannot be distinguished from other pneumonia clinically; 2-10 fold increase in liver function tests, leukocytosis and thrombocytopenia, erythrocyte sedimentation rate and creatine kinase increase may be observed or laboratory findings may be normal. An immunofluorescent antibody (IFA) test, which is a serological reference method, should be requested from patients suspected for the diagnosis of Q fever.

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