Q fever endocarditis revisited

A diagnosis of Q fever endocarditis was made in 7 patients, 6 with predispo sing factors and 3 with occupational risk factors. Prompt recognition of Coxiella burnettii endocarditis is required when clin ical signs of endocarditis such as fever, anaemia, elevated liver transamin ases, congestive cardiac failure are accompanied by negative blood cultures . Serological evidence of elevated antibody titres to Phase I and Phase II antigens of Coxiella burnettii are diagnostic. Prolonged antimicrobial therapy combined with surgery has resulted in the m arked reduction of mortality from 50 per cent to 17 per cent when Q fever e ndocarditis is revisited almost 20 yr later.