Q fever

Last Updated: 2023-07-07

Author(s): Anzengruber F., Navarini A.

ICD11: 1C33

Holbroock 1937.

Rickettsiosis caused by Rickettsia burneti.

  • Occurring worldwide.
  • Particularly are farmers.
  • Pathogen: Rickettsia burneti.
  • Infection occurs via inhalation of sheep tick faeces. Furthermore, wool, milk or even meat can be contaminated.
  • Transmission from human to human is extremely rare.
  • A partly ulcerated, possibly crusted papule is seen at the site of inoculation.
  • Locoregional lymph node adenopathy.
  • Febrile temperatures.
  • Maculopapular exanthema (initially on wrists and ankles).
  • Atypical pneumonia, conjunctivitis, cough.
  • It may involve kidney, liver and CNS.
  • If necessary, intensive medical measures and transfer to the intensive care unit.
  • Control of vital signs, fluid balance, electrolytes and protein replacement.

     

    Topical therapy

  • Jacutin® gel (lindane) 0.3%. Use not recommended due to neurotoxicological side effects. In Switzerland, Jacuin® is no longer on the market.
  • Loxazole Lot. 1% (reapply after 1 and 2 weeks).
  • Permethrin 5% in e.g.: Excipial U Lipolotio.
  • Prioderm® shampoo (reapply after 1 and 2 weeks).
  • Paranix® Sprax (dimeticone), exposure time: 15 min., repeat after 7 days if necessary
  • Lausweg® foam solution, exposure time: 15 min. , repeat after 7 and 14 days.
  • Rausch Laus stop® cream, exposure time: 20 min., repeat after 7 and 14 days.

     

    Systemic therapy

  • Doxycycline p.o. 100 mg 2x tgl. for 8-10 days.
  • Alternatively: Ciprofloxacin p.o 500 mg 2x tgl.
  • In severe cases, if necessary, i.v. glucocorticoids 100 mg/d for 2-3 days.
  1. Galache, C., et al., Q fever: a new cause of 'doughnut' granulomatous lobular panniculitis. Br J Dermatol, 2004. 151(3): p. 685-687.
  2. Frangoulidis, D. and S.F. Fischer, [Q fever]. Dtsch Med Wochenschr, 2015. 140(16): p. 1206-8.
  3. Schneeberger, P.M., et al., Q fever in the Netherlands - 2007-2010: what we learned from the largest outbreak ever. Med Mal Infect, 2014. 44(8): p. 339-53.
  4. Bielawska-Drozd, A., et al., Q fever--selected issues. Ann Agric Environ Med, 2013. 20(2): p. 222-32.
  5. Kersh, G.J., Antimicrobial therapies for Q fever. Expert Rev Anti Infect Ther, 2013. 11(11): p. 1207-14.

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