In what circumstances should I consider referring a patient with suspected Q Fever to a specialist?

Consider referring a patient with suspected Q fever to a specialist in the following circumstances:

• If the patient is at increased risk of complications or has a confirmed diagnosis and requires further testing and follow-up, seek advice from infectious diseases, microbiology, or virology specialists.
• If the patient presents with severe or persistent symptoms, such as prolonged fever or complications like endocarditis, specialist referral is warranted.
• If there is uncertainty about diagnosis, management, or the need for laboratory monitoring, contact the local infectious diseases or microbiology department for advice.
• Patients with underlying conditions that may predispose to chronic Q fever or complications should be referred for specialist assessment.

These recommendations align with the general principle of seeking specialist advice for infections with potential complications or diagnostic uncertainty, as exemplified in UK guidelines for similar infections (e.g., parvovirus B19) where specialist input is advised for at-risk patients or those with severe symptoms ¹.