Q fever physical examination

Patients with Q fever usually appear ill. Physical examination of patients with Q fever usually shows fever, pneumonia, and hepatomegaly.

Examination of a patient with Q fever might reveal the following signs:

• Fever: High grade fevers that are usually accompanied by chills and sweats^[1][2]
• Tachycardia
• Tachypnea

• Patient looks ill

• Maculopapular or punctate rash
• Erythema nodosum
• Spider nevi if hepatic decompensation is present

• Jaundice
• Congested neck veins if endocarditis or myocarditis is complicated by heart failure^[3]

• Minimal auscultatory findings in most cases
• Crackles especially in the lower lung fields
• Decreased breath sounds if pleural effusion is present

• Hepatomegaly
• Ascites if chronic hepatitis ensues

• S3 due to hyperdynamic circulation
• New onset murmur if endocarditis is present
• Pericardial rub and distant heart sounds if pericarditis and pericardial effusion are present

• Neck rigidity and positive Brudsiniski and Kuring signs
• Signs of increased intracranial pressure (vomiting, convulsions, papilledema, etc)

• Tenderness on palpation of the affected joints and bones
• Lower limb edema in presence of heart failure

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