Infectiologic differential diagnosis of chronic Lyme disease and so ...

The decisive diagnostic information with regard to a possible Q fever is thus the
person’s occupational activity or the contact with agriculture and livestock. In
sporadic cases, frequent consumption of raw milk or contact with diseased cattle
(abort) can be an indication of an infection hazard.
Significant disease manifestations:
- Transitory influenza-like clinical picture
- Pneumonia
- Hepatitis
- Other manifestations:
� Erythema
� Pericarditis / Myocarditis
� Meningitis / Encephalitis [318-320]
� Myelitis [316, 317]
� Chronic fatigue [340-345]
The chronic course of Q fever can persist for months or years. In this context,
chronic endocarditis is the predominant disease manifestation. A chronic course
occurs in approximately 1 to 5% of those patients who were afflicted with an acute Q
fever. In addition to the endocarditis, infection of aneurysms and vascular
prostheses is a frequent occurrence.
The entire symptomatology of chronic Q fever is presented in Table 24 [315, 345,
347-350].
Table 24
Symptomatology of chronic Q fever
Endocarditis
Infection of aneurysms
Infection of cardiovascular prosthetic material
Fatigue 26%
Headaches 1%
Myalgias 2%
Increased perspiration 6%
Dyspnea 5%
Arthralgias 2%
46