Q fever in military and paramilitary personnel in conflict zones: case report and review.

We present the case of a 44-year-old civilian security officer medically evacuated from Iraq with acalculous cholecystitis and Guillain-Barré syndrome and subsequently found to have acute Q fever. The presenting features of Q fever in military and related personnel deployed to Iraq and Afghanistan are reviewed and the use of PCR in early diagnosis of Q fever is discussed. The atypical presentation in this case encourages clinicians to have a low threshold for considering Q fever as part of the differential diagnosis in soldiers and related personnel returning from these areas of high endemicity.