Q fever — RACP Adult Medicine MCQ

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ModerateInfectious diseasesQ feverRACP Adult Medicine

A 44-year-old abattoir worker has fever, severe headache and atypical pneumonia. Liver enzymes are mildly elevated. Blood cultures are negative and serology later shows Coxiella burnetii phase II IgM and IgG. What is the most likely diagnosis?

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Correct answer: C — Q fever

Occupational animal exposure, atypical pneumonia, hepatitis and Coxiella serology support Q fever. Psittacosis is linked to birds, influenza is usually diagnosed virologically and pneumococcal pneumonia is more often lobar with positive bacterial features. Histoplasmosis is less typical in this Australian occupational context.

Reference: Therapeutic Guidelines (eTG) Antibiotic; Australian Q fever guidance