Which of the following statements best describes a chronic Q fever outcome?

• A. Endocarditis is a recognized outcome
• B. Acute gastroenteritis is the most common presentation
• C. Dermal rash is most common
• D. Acute liver failure is the typical presenting feature

Answer: (A)

Chronic Q fever most often shows up as endocarditis, especially in people with preexisting valve disease or prosthetic valves. Coxiella burnetii can persist in the body after an initial infection, and the endocardium becomes a common site for this long-lasting infection. This form is typically culture-negative, which makes serology crucial: high phase I IgG titers against Coxiella burnetii and imaging showing new or worsening valvular disease or vegetations are key clues. Treatment is long-term and typically involves antibiotics such as doxycycline, often with additional drugs like hydroxychloroquine, and may require surgical valve intervention in some cases.

Other statements don’t fit the typical picture of chronic Q fever. Acute Q fever more commonly presents with pneumonia or hepatitis rather than gastroenteritis, and dermal rashes or acute liver failure are not characteristic chronic outcomes.