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Q Fever — SCE Infectious Diseases MCQ

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ModerateTropical & Imported InfectionsQ FeverSCE Infectious Diseases

A 38-year-old veterinarian presents with a flu-like illness followed by pneumonia and hepatitis. Coxiella burnetii phase II IgG is 1:512 and phase I IgG is 1:64. He has no valvular heart disease. What is the most appropriate treatment?

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Correct answer: D — Doxycycline 100 mg BD for 14 days

This serological pattern (high phase II IgG with low phase I IgG) is consistent with acute Q fever. Acute Q fever is treated with Doxycycline 100 mg BD for 14 days. Chronic Q fever (typically endocarditis, diagnosed by phase I IgG ≥1:800) requires prolonged treatment with Doxycycline plus Hydroxychloroquine for at least 18 months. This patient has acute disease without cardiac involvement, so short-course Doxycycline is appropriate.

Reference: UKHSA 2022 – Q fever guidelines; PHE 2018 – Q fever clinical guidance