Gram negative pleomorphic coccobacillus; lives in phagolysosomes. And you think your apartment is located in a bad neighborhood.
Exposures to cows, sheep, and goats, European rabbits and other animals as well. Especially if the patient is exposed to placentas; it can survive in soil for a long period of time. Being seen by the (few) troops returning from Iraq (along with Leishmania and very resistant Acinetobacter). It can also be found in filth flies (PubMed). Time flies like an arrow, filth flies like a dung pile. So don't be eating a filth fly.
Common in veterinarians (22% of those tested). Risk factors included age >46 years, routine contact with ponds, and treatment of cattle, swine, or wildlife (PubMed).
May even be in seals in Greenland. And don't stand under 3-toed sloths, the may be excreting Coxiella on you (PubMed).
And even weirder? This is a wack-a-loon therapy whereby people get injected with "fetal sheep cells" and with it Q fever (PubMed) as part of live cell therapy. Why anyone would think injection embryonic cells from cows, sheep or sharks is a good idea is beyond me.
Fever (self limited), pneumonia with headaches (in a series from New Zealand, headache was the predominant presenting symptom, leading to a meningitis evaluation rather than a pneumonia presentation) and hepatitis (has a donut cell on histopathology), endocarditis (culture negative).
The diagnosis of endocarditis is often made serologically as serology goes from phase II to phase I (yes, its backwards) and this can take three months so patients with acute Q fever need long term serologic follow up (PubMed).
There is a post infectious fatigue after Q fever (as with many infections) that does NOT respond to doxycycline but does get better with cognitive-behavioral therapy (PubMed).
Acute Q fever: Doxycycline 100 bid x 14 d.
Endocarditis therapy is perhaps forever.
There was a cool case of four guys playing poker in a garage where a cat was giving birth. Three of the 4 came down with Q fever.