SHM Converge Scientific Abstract ePoster Gallery-A Quite Unusual Presentation of Q Fever

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This case describes a 33-year-old man who presented with acute epigastric pain and was diagnosed with acute pancreatitis based on symptoms, elevated lipase, and imaging. His pancreatitis was initially attributed to alcohol use, though this later appeared to be an incomplete explanation. During hospitalization, he also developed transaminitis, and imaging revealed cholelithiasis without obstruction.<br /><br />A more detailed history obtained later uncovered several months of malaise and weight loss before admission, as well as an occupational history significant for migrant agricultural work across the U.S., including recent dairy farming. Because of this exposure history, Infectious Disease was consulted and zoonotic testing was pursued. This testing confirmed active Coxiella burnetii infection, the organism responsible for Q fever.<br /><br />The patient was treated with doxycycline and hydroxychloroquine, with subsequent improvement in malaise, epigastric pain, appetite, and weight. The report emphasizes that Q fever usually causes vague, nonspecific symptoms, which can delay diagnosis and make it easy to miss unusual manifestations such as pancreatitis. Although the exact mechanism is unclear, the authors suggest either direct pancreatic inflammation or immune-mediated injury.<br /><br />The key lessons are that infectious causes of pancreatitis, though rare, should be considered when the presentation is atypical or when risk factors such as animal exposure or agricultural work are present; that a thorough history can prevent diagnostic anchoring; and that certified medical interpreters should always be used for non-native English speakers to ensure accurate communication and diagnosis.

Asset Subtitle

Sophia S.F Bostwick

Meta Tag

Author List Diana W. Aiken, Sophia S.F Bostwick

Category Clinical Vignettes

Concept Q fever

Concept Acute Pancreatitis

Concept Comprehensive history

Concept Zoonotic exposure

Concept Diagnostic Anchoring

Distinguished Non-Finalist

Presenter Organization Oregon Health and Science University - Hillsboro Medical Center

Presenting Author Sophia S.F Bostwick

Track Adult

Keywords

acute pancreatitis

Q fever

Coxiella burnetii

doxycycline

hydroxychloroquine

zoonotic infection

dairy farming exposure

transaminitis

cholelithiasis

medical interpreter

Q fever

Acute Pancreatitis

Comprehensive history

Zoonotic exposure

Diagnostic Anchoring