SHM Converge Scientific Abstract ePoster Gallery-Fever That Doesn't Go Away

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This document presents a case of prolonged fever ultimately linked to Q fever, a zoonotic infection caused by <em>Coxiella burnetii</em>, which is commonly acquired through inhalation of contaminated animal waste or soil from livestock such as goats, sheep, and cows.  

A 63-year-old man developed fever and bilateral leg pain and was found to have bilateral deep vein thrombosis. Despite anticoagulation and broad-spectrum antibiotics, he continued to have persistent fever and leukocytosis. An extensive evaluation, including CT imaging, spine MRI, bone scan, tagged white blood cell scan, blood cultures, stool studies, and bone marrow biopsy, did not identify a clear cause. Later serology was positive for <em>C. burnetii</em>, and further history revealed exposure to goats during frequent farm visits in India about a year earlier.  

Because chronic Q fever can cause endocarditis, aneurysms, and granulomatous infection, he underwent transesophageal echocardiography and CT angiography, both of which were negative for these complications. He was treated with doxycycline and moxifloxacin and followed by infectious disease specialists.  

The report emphasizes that Q fever can be difficult to diagnose because acute infection may be asymptomatic or nonspecific, and serology may be negative early in illness. Clinicians should suspect Q fever in patients with prolonged fever, leukocytosis, thrombocytopenia, or elevated liver enzymes, especially when routine workup is unrevealing and there is animal exposure history. Diagnosis can be made by serology or PCR, while chronic Q fever requires careful evaluation for cardiac or vascular involvement.  

Recommended treatment for acute Q fever is doxycycline for 14 days. Chronic Q fever, especially endocarditis, requires prolonged therapy such as doxycycline plus chloroquine for 18–24 months or longer.

Asset Subtitle

Shen Chen

Meta Tag

Author List Saritha Thota, Shen Chen

Category Clinical Vignettes

Concept Q fever

Concept Endocarditis

Concept Doxycycline

Concept Zoonosis

Concept Aerosol Exposure

Distinguished Non-Finalist

Presenter Organization Emory Johns Creek Hospital

Presenting Author Shen Chen

Track Adult

Keywords

Q fever

Coxiella burnetii

prolonged fever

zoonotic infection

goat exposure

deep vein thrombosis

serology

endocarditis

doxycycline

chronic Q fever

Q fever

Endocarditis

Doxycycline

Zoonosis

Aerosol Exposure