An Q fever case interfere with Crimean Congo hemorrhagic fever

Q fever is a zoonotic infection caused by the pathogen Coxiella burnetii. Main sources of bacteria are cattle, ships and goats. Human is usually infected by inhaled particles or digestion of contaminated milk and milk products. Q fever can present with a wide spectrum of clinical manifestations. The diagnosis of Q fever cases is missed out since the acute sickness generally appears asymptomatic and mildly symptomatic disease. Acute infections can occur sporadic or sometimes can cause outbreaks. Q fever should be considered in the differential diagnosis in the cases presenting with pneumonia, hepatitis or other disease symptoms with fever and had any epidemiological relationship. The Crimean Congo hemorrhagic fever (CCHF) can interfere with Q fever symptoms according to the clinical and laboratory findings. In this paper, a male patient who was living in the province of Bolu and engaged in animal husbandry was presented. He was admitted with fever, chills, headache, pain in the back of the eye and was diagnosed as Q fever. He was first diagnosed as Crimean Congo haemorrhagic fever (CCHF) because of thrombocytopenia and high transaminase and CPK levels, but PCR and serologic tests for CCHF were negative. The diagnose was made by the positive indirect fluorescent antibody test for Q fever, the titer of Coxiella burnetii IgG (Phase 2) antibodies was 1/128. The clinical and laboratory findings were improved with the doxycycline treatment. As a result, in cases working in animal husbandry and having high fever, headache and high liver enzyme tests, Q fever should be kept in mind in the differential diagnosis