Q-FEVER ASSOCIATED MYOCARDITIS IN A 14-YE AR-OLD BOY

A 14-year-old boy presented with the symptoms and clinical signs of my ocarditis. Ventricular arrhythmias were the main manifestation. Dilate d left ventricle with slightly impaired contractility and spongy appea rance of the myocardium were also noted. Laboratory signs of an acute infectious disease were absent, but a significant rise in the compleme nt fixation titer for Coxiella burnetii was observed. Treatment with o ral tetracyclins for 6 months resulted in improvement of ventricular a rrhythmias and normalization of left ventricular dimensions and struct ure over the following months. Cardiac involvement in Q fever is rare, and with it endocarditis is usually seen as a chronic form of the dis ease. Myocarditis associated with Q fever has been reported only in so me rare cases but not in children. The case reported here illustrates that the diagnosis of Q fever should also be considered in a case of m yocardial involvement in an infectious disease of unknown etiology.