Q Fever

A 75-year-old retired farmer living in rural Saskatche-wan, presented with fever, night sweats, and fatigue for three weeks and a two-day history of bilateral calf pain and lower extremity weakness in August. He report-ed occasional shortness of breath, but denied cough, altered bowel habit, chills, rash, arthralgia, or headache. He had no recent travel history or sick contacts, though he did have contact with animals including sev-eral miniature horses and a pet rabbit on his farm, and frequent attendance at horse shows. In the weeks prior to his presentation he had been working on the farm cleaning out an old barn. There was a positive remote history of multiple tick bites.