Q Fever with Clinical Features Resembling Systemic Lupus Erythematosus

A 23yearold woman with prolonged fever, rash, and pericarditis associated with high titers of antinuclear, antiSm, and antiRNP antibodies was suspected of having systemic lupus erythematosus (SLE). However, we also considered infectious diseases, particularly Q fever, as the Creactive protein level was elevated and the patient reported contact with zoo animals around two weeks before the onset. The condition responded rapidly to administration of minocycline; symptoms resolved without using steroids. Thereafter, no recurrence of the illness was observed. Titer of Coxiella burnetii antibody was high and the illness was accordingly diagnosed as acute Q fever rather than SLE.