Q Fever with Unusual Exposure History: A Classic Presentation of a Commonly Misdiagnosed Disease

Table 1

Case-patient laboratory test results, Montana, 2011.

Laboratory test	Result
White blood cell count (g/L)	4.1
Platelet count (g/L)	115
Blood urea nitrogen (mg/dL)	23
Creatinine (mg/dL)	1.7
Aspartate aminotransferase (IU/L)	132
Alanine aminotransferase (IU/L)	193
Alkaline phosphatase (IU/L)	106
Coxiella burnetii antibody titers^† by specimen
Acute^‡
IgG^*/IgM phase I	<1 : 16/not done
IgG/IgM phase II	<1 : 16/<1 : 16
Convalescent^§
IgG/IgM phase I	≥1 : 256/1 : 64
IgG/IgM phase II	≥1 : 256/≥1 : 256
SFGR antibody titers^† by specimen
Acute^‡
IgG	1 : 64
IgM	<1 : 64
Convalescent^§
IgG	1 : 128
IgM	<1 : 64
Borrelia burgdorferi antibody^¶ (IgG and/or IgM) by specimen
Acute^‡	Negative
Convalescent^§	Negative
West Nile virus antibody^¶
IgG	Negative
IgM	Negative

^*IgG: immunoglobulin G; IgM: immunoglobulin M; SFGR: spotted fever group rickettsiae.
^†Testing performed using indirect immunofluorescence assay.
^‡Acute specimen collected on June 29, 2011.
^§Convalescent specimen collected on July 12, 2011.
^¶Testing performed using enzyme-linked immunosorbent assay (ELISA); therefore, no titers reported.