Q fever is an acute zoonotic illness that was first discovered in Queensland, Australia in 1935 among meat workers. Acute Q fever initially presents as a self-limiting febrile illness lasting 1 to 3 weeks with high fevers, headaches, fatigue, and myalgias. This case report serves to highlight this illness as a rare albeit important diagnosis in addition to showing how it can progress into other manifestations such as chronic Q fever and Q fever fatigue syndrome.

A 55-year-old male presented to the neurology clinic for pain in his shoulders and neck. During this visit, the patient stated he was diagnosed with Q fever by an infectious disease doctor a year ago. He has a past medical history of diabetes, hemochromatosis, and avascular necrosis. On examination, the patient was in no distress but reported muscle tenderness with palpation of his left shoulder, upper back, and neck musculature. Sensation to light touch and muscle strength were both intact. Diagnostic testing included: Q fever titer of 1:64, bone marrow biopsy, and ova/parasite testing which all supported his diagnosis. The patient was started on oral ciprofloxacin, doxycycline, and received a pic line in which he received IV doxycycline for 14 days. 

Patient is currently on oral doxycycline and is following up regularly with his infectious disease doctor.

The patient’s continued symptoms despite antibiotics suggests further involvement. Q fever fatigue syndrome (QFS) is a debilitating condition involving persistence of fatigue, headaches, and blurry vison. Q fever warrants a heightened awareness from the health care community due to its connection to the animal and food industry. If the world was more aware of Q fever, then we believe this would lead to more accurate, quicker diagnoses and the possibility of new developments in treatments of the less common manifestations namely chronic Q fever and QFS.