Q fever is a worldwide zoonosis, caused by Coxiella burnetii, that can be easily diagnosed in its usual clinical presentation. However, Q fever may mimic systemic autoimmune and inflammatory disorders making its recognition very challenging. We present a case of acute Q fever presenting in a patient with latent undiagnosed. Systemic Lupus Erythematosus (SLE): diagnostic challenges, potential pitfalls and therapeutic issues encountered in the management of this patient were presented and discussed.