CLINICAL ASPECTS OF Q FEVER IN SOUTHERN CALIFORNIA; A STUDY OF 80 HOSPITALIZED CASES

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Abstract
80 hospitalized cases of Q fever, a disease which had been found to be occurring in the general population of southern California, were studied. The most common symptom complex was that of a sudden onset of fever, chilly sensations, malaise, and anorexia, followed in a few days by a slight hacking cough and mild pleuritic chest pain. The patients were febrile, had a relative bradycardia, and appeared acutely ill. Findings resulted in classification of cases into three groups: (1) those resembling "primary atypical pneumonia" (50% of cases); (2) those simulating meningitis (25% of cases); and (3) those without localizing findings, the "influenza-like group" (25% of cases). Blood counts were variable but commonly showed a mild poly-morphonuclear leukocytosis and lymphocytopenia. The erythrocyte sedimentation rate was elevated in every case. Chest roentgeno-grams showed infiltrations in the majority of cases, usually a uniform segmental or lobar consolidation. Other laboratory studies were normal. The fever persisted between 7 and 15 days, despite therapy with penicillin, sulfonamides, roentgen-ray, streptomycin, or p-aminobenzoic acid. The complement-fixation test for Q fever became positive during the 2d week of illness. In every case the final diagnosis of Q fever was dependent upon this test.
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