Q fever pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Q fever is a disease caused by C. brutenii, an intracellular gram-negative proteobacterium. The disease can have a wide range of clinical presentations and affect many organ systems due to the unique virulence factors of the organism.

Pathophysiology

Transmission

The organism is transmitted through:[1]

  • Aerosoloes: Inhalation of contaminated aerosoles is the main mode of transmission.
  • Ingestion of raw dairy products
  • Vertical (mother to fetus) transmission has been reported
  • Parentral
  • Through tick bites

Pathogenesis

C. Brutenii has the ability to exist in 2 forms:

Small cell form[2]

Often described as the spore form of C. Brutenii Resists the external environmental factors as heat, pressure and disinfectants for long periods.

Large cell form

The active form of the organism large cell form persists in the macrophages inside acidic vacuoles.

Q fever as a biological weapon

  • Because of its route of infection it can be used as a biological warfare agent.
  • Q-fever is category "B" agent. It is highly contagious and very stable in aerosols in a wide range of temperatures.
  • Just 1-2 particles are enough to infect an individual.
  • Q-fever microorganisms may survive on surfaces up to 60 days (like sporulating bacteria).
  • According to WHO estimates[4], an amount of 50 kg of C. Brutenii if spread in an area of 2 square kilometers is capable of:
  • Infecting 500,000 humans
  • Killing 150 individuals
  • Causing acute illness in 125,000 individuals
  • Causing chronic illness in 9,000 individuals

Microscopic pathology

Coxiella brutenii
Immunohistochemical detection of Coxiella burnetii in resected cardiac valve of a 60-year-old man with Q fever - By Mahamat A, Edouard S, Demar M, Abboud P, Patrice J-Y, La Scola B, et al. -Public domain-, via Wikime

References

  1. Marrie TJ (1990). "Q fever - a review". Can. Vet. J. 31 (8): 555–63. PMC 1480833. PMID 17423643.
  2. "Diagnosis of Q Fever".
  3. Choyce DP (1992). "Anterior chamber lens exchange". J Cataract Refract Surg. 18 (5): 537. PMID 1489455.
  4. "apps.who.int" (PDF).
  5. "Q Fever on JSTOR".

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