Resumo

PINTO, Susana Silva et al. The diagnostic challenge of a zoonosis. Rev Port Med Geral Fam [online]. 2020, vol.36, n.4, pp.355-359. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v36i4.12615.

Introduction: Q fever is a zoonosis, caused by Coxiella burnetii. This bacterium is present in animal products, especially sheep, goats and cattle and is transmitted to the human by inhalation of aerosols. Being a notifiable disease in Portugal since 1999, it is epidemiologically relevant all over the world, both in its acute form, with reports of several outbreaks in the last decade, and in its persistent localized form, being the most common cause of endocarditis with blood cultures negative. Case description: A 47-year-old woman who goes to primary health care with prolonged fever without evident focus, after attending a goat's delivery, was referred to the hospital emergency service. Due to the clinical presentation, analytical corroboration, and highly suggestive epidemiology, she started empirical therapy for brucellosis with doxycycline and streptomycin. Subsequently, in the infection clinic, a diagnosis of Q fever was confirmed and adjusted therapy. The patient completed 14 days of doxycycline treatment, with clinical improvement and no complications. Comment: Patients with Q fever may present with a broad spectrum of disease manifestations: the absence of symptoms, mild to severe symptoms, as well as persistent localized disease. Due to the non-specificity of the signs and symptoms of Q fever, laboratory diagnosis is essential for confirmation of clinical suspicion. For treatment, doxycycline is the first-line antibiotic for the treatment of this infection. This clinical case shows that the accessibility of primary health care currently promotes the first point of contact with the National Health Service and the role of the family doctor as responsible for articulation with other specialties.

Palavras-chave : Zoonoses; Q fever; Primary health care.

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