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Q Fever — RACP Adult Medicine MCQ

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ModerateInfectious DiseasesQ FeverRACP Adult Medicine

A 45-year-old man presents with a 2-week history of high-grade fever, hepatosplenomegaly, and a rash. He is a farmer in rural Queensland. Blood cultures are negative. Serological testing for Coxiella burnetii phase II IgG is markedly elevated. What is the first-line treatment?

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

Acute Q fever (caused by Coxiella burnetii, acquired from livestock/animal products) is treated with doxycycline 100 mg BD for 14 days. Q fever is notifiable in Australia. Risk groups include farmers, abattoir workers, and veterinarians. Serological follow-up at 6 and 12 months is important to detect transition to chronic Q fever (especially endocarditis – phase I IgG ≥1:800). Chronic Q fever requires prolonged treatment with doxycycline plus hydroxychloroquine for ≥18 months.

Reference: eTG – 2025 – Antibiotic Guidelines; CDNA – 2024 – Q Fever National Guidelines