COXIELLA BURNETTI ENDOCARDITIS - ABOUT ON E CASE

Chronic forms of Q fever (endocarditis) are rare, but are responsible for severe and desperately reccurent infections, resulting in multiple valve replacements with a reserved prognosis. The authors report the case of a 35-year-old patient with a known history of rheumatic fever, who developed blood culture negative infectious endocarditis on a mit ral bioprosthesis. The diagnosis of Q fever was based on serological a rguments. Despite long-term antibiotic therapy, serology remained stro ngly positive and was associated with repeated mitral valve disinserti on. The patient died immediatly after the fourth operation in a contex t of haemodynamic failure. This clinical case emphasizes the importanc e of performing Q fever serology in any case of culture negative endoc arditis and the therapeutic difficulties encountered in chronic recurr ent endocarditis.