(T/F) Chronic Q fever is the most common form of Coxiella burnetii

• A. True
• B. False
• C. False - rare, develops in <5% of acute cases
• D. Cannot be determined

Answer: (C)

Most Q fever infections present as an acute illness, while chronic disease is the exception rather than the rule. After an initial infection, a minority of people go on to develop chronic Q fever, and this progression is relatively rare—commonly cited as developing in less than 5% of acute cases. Chronic disease tends to appear months or years later and is more likely in individuals with particular risk factors, such as preexisting heart valve disease or prosthetic valves, vascular grafts or aneurysms, and certain states of immunosuppression. The most recognizable chronic manifestation is endocarditis, though other vascular infections can occur. Diagnosis relies on serology showing high phase I IgG antibodies and, in practice, the clinical picture plus serologic patterns. Treatment requires prolonged, combination antibiotic therapy to address the organism’s intracellular persistence. In short, the statement overstates the frequency of chronic disease; the chronic form is rare and develops in a small fraction of those with acute Q fever.