Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content ++ Key Features ++ Caused by inhalation of Coxiella burnetii Exposure to farm animals (sheep, goats, cattle) and pets Unpasteurized milk from infected animals may also transmit disease Flu-like illness (fever, severe headache, myalgia) Cough; atypical pneumonia Hepatomegaly and hepatitis ++ Clinical Findings ++ Abrupt onset of self-limited flu-like syndrome occurring 10–25 days after exposure Abdominal pain, vomiting, chest pain, and dry cough are prominent in children Hepatosplenomegaly is common Illness lasts 1–4 weeks and frequently is associated with weight loss ++ Diagnosis ++ Leukopenia with left shift is characteristic Aminotransferase and γ-glutamyl transferase levels are elevated Diagnosis is made by finding an antibody response (fourfold rise or single high titer in ELISA; IFA, or CF antibody assay) to the phase II organism Chronic infection is indicated by antibody against the phase I organism Pneumonitis occurs in 50% of patients Multiple segmental infiltrates are common, but the radiographic appearance is not pathognomonic ++ Treatment ++ Self-limited, illness typically lasts 1–2 weeks without therapy Doxycycline shortens course of uncomplicated illness Therapy is continued for several days after the patient becomes afebrile (usually 10–14 days) Quinolones are also effective GET ACCESS TO THIS RESOURCE Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. Access My Subscription GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessPediatrics 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessPediatrics Full Site: One-Year Individual Subscription $595 USD Buy Now View All Subscription Options