Infection occurs through inhalation of sheep tick excrement. Further the wool, milk or even the meat can be contaminated.
Transmission from person to person is extremely rare.
In the area of the inoculation site a partly ulcerated, possibly encrusted papule appears.
Locoregional lymph nodeadenopathy.
Febrile temperatures.
Maculopapular exanthema (initial at wrists and ankles).
Atypical pneumonia, conjunctivitis, cough.
Kidney, liver and CNS may be involved.
If necessary, intensive medical measures and transfer to the intensive care unit.
Control of vital parameters, fluid balance, electrolytes and protein replacement.
Topical therapy
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 (Dimeticon), application time: 15 min., if necessary repeat after 7 days.
Lausweg® foam solution, contact time: 15 min. Repeat after 7 and 14 days.
Rausch Laus stop® cream, application time: 20 min., repetition after 7 and 14 days.
Systemic therapy
Doxycycline p.o. 100 mg 2x daily for 8-10 days.
Alternative: Ciprofloxacin p.o. 500 mg 2x daily.
In pronounced cases intravenously glucocorticoids 100 mg/d for 2-3 days if necessary.
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Frangoulidis, D. and S.F. Fischer, [Q fever]. Dtsch Med Wochenschr, 2015. 140(16): p. 1206-8.
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.
Bielawska-Drozd, A., et al., Q fever--selected issues. Ann Agric Environ Med, 2013. 20(2): p. 222-32.
Kersh, G.J., Antimicrobial therapies for Q fever. Expert Rev Anti Infect Ther, 2013. 11(11): p. 1207-14.
