Which statement is not true of Coxiella burnetii?

• A. It is an obligate intracellular parasite.
• B. It is transmitted from animals to humans by inhalation.
• C. A rash appears first on the extremities and then on the trunk.
• D. Is the etiologic agent of Q fever, which may be acute or chronic

Answer: (C)

Coxiella burnetii is an obligate intracellular bacterium that causes Q fever. Humans usually acquire infection by inhaling aerosols from infected animals, especially birth products from sheep, goats, or cattle. The disease can be acute—with fever, malaise, myalgia, and sometimes pneumonia or hepatitis—and may become chronic, most notably as endocarditis. A rash is not a typical feature of Q fever and, if it occurs, it is not a defining presentation. Therefore, the statement about a rash appearing first on the extremities and then on the trunk is not true. The other points correctly describe the organism, its transmission by inhalation, and its ability to cause acute or chronic Q fever.