Editing Fever Q (section)

== Signs and symptoms ==
The typical incubation period is between two to three weeks.<ref name="brunette">{{Cite book|author=Centers for Disease Control and Prevention|editor-last=Brunette|editor-first=Gary W., MD, MS|display-editors=etal|title=CDC Health Information for International Travel 2012|url=https://archive.org/details/cdchealthinforma0000unse/page/270/mode/2up|url-access=registration|publisher=[[wikipedia:Oxford University Press|Oxford University Press]]|year=2012|pages=270–271|chapter=Q Fever|chapter-url=https://books.google.com/books?id=5vCQpr1WTS8C&pg=PA270|isbn=978-0-19-976901-8|issn=0095-3539|access-date=2024-09-26|df=mdy-all}}</ref> Common presentations include [[wikipedia:Influenza-like illness|flu-like symptoms]] with an abrupt onset of [[wikipedia:Fever|fever]], [[wikipedia:Chills|chills]], profuse [[wikipedia:Perspiration|perspiration]], [[wikipedia:Malaise|malaise]], severe [[wikipedia:Headache|headache]], [[wikipedia:Myalgia|muscle]] and [[wikipedia:Arthralgia|joint pain]], [[wikipedia:Anorexia (symptom)|loss of appetite]], [[wikipedia:Respiratory tract#Upper respiratory tract|upper respiratory tract]] problems, a dry [[wikipedia:Cough|cough]], [[wikipedia:Pleurisy|pleuritic pain]], [[wikipedia:Confusion|confusion]], [[wikipedia:Nausea|nausea]] and [[wikipedia:Gastroenteritis|gastroenteritis]]. However, roughly half of infected individuals are [[wikipedia:Asymptomatic|asymptomatic]].<ref name="brunette" />

During its course, the disease can progress to an [[wikipedia:Atypical pneumonia|atypical, or "walking," pneumonia]] which can result in life-threatening [[wikipedia:Acute respiratory distress syndrome|acute respiratory distress syndrome]] (ARDS), with such symptoms usually occurring during the first four to five days of infection.{{Citation needed}}

Less often, Q&nbsp;fever causes granulomatous (chronic) [[wikipedia:Hepatitis#Bacterial hepatitis|hepatitis]], which may be asymptomatic or becomes symptomatic with malaise, fever, [[wikipedia:Hepatomegaly|liver enlargement]] and [[wikipedia:Quadrants and regions of abdomen|abdominal right upper quadrant]] pain. [[wikipedia:Elevated transaminases|Elevated transaminase]] (liver enzymes) values are common, however [[wikipedia:Jaundice|jaundice]] is not. [[wikipedia:Retinal vasculitis|Retinal vasculitis]] is also a known symptom, though rare.<ref name="kuhne">{{Cite journal|last1=Kuhne|first1=F.|last2=Morlat|first2=P.|last3=Riss|first3=I.|last4=Dominguez|first4=M.|last5=Hostyn|first5=P.|last6=Carniel|first6=N.|last7=Paix|first7=M.A.|last8=Aubertin|first8=J.|last9=Raoult|first9=D.|last10=Le Rebeller|first10=M.J.|title=La vascularite A29, B12, est-elle déclenchée par l'agent de la fièvre Q? (Coxiella burnetii)|trans-title=Is A29, B12 vasculitis caused by the Q fever agent? (Coxiella burnetii)|journal=Journal Francais d'Ophtalmologie|year=1992|volume=15|issue=5|pages=315–321|issn=0181-5512|pmid=1430809|oclc=116712679|language=fr}}</ref>

The chronic form of Q&nbsp;fever is virtually identical to [[wikipedia:Endocarditis|endocarditis]] ([[wikipedia:Inflammation|inflammation]] of the [[wikipedia:Endocardium|inner lining of the heart]], often involving the [[wikipedia:Heart valve|heart valves]], as well)<ref name="chronic">{{Cite journal|last1=Karakousis|first1=Petros C.|last2=Trucksis|first2=Michele|last3=Dumler|first3=J. Stephen|title=Chronic Q&nbsp;Fever in the United States|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489455/|journal=Journal of Clinical Microbiology|date=June 2006|volume=44|issue=6|pages=2283–2287|pmc=1489455|pmid=16757641|doi=10.1128/JCM.02365-05|access-date=2024-09-26|df=mdy-all}}</ref> and can occur months or decades following the initial infection. It is usually fatal if left untreated, but with appropriate treatment the mortality rate falls to roughly 10%.{{Citation needed}}