Q fever endocarditis: is it always subacute or chronic?

Q fever is a zoonotic disease caused by Coxiella burnetii, which is an obligatory intracellular bacterium, and could not be cultured in routine blood culture bottles. Although C.burnetii is reported to be the causative agent in approximately 50% of blood culture-negative infective endocarditis in developed countries, its role in Turkey is yet to be defined. Clinical course Q fever endocarditis is generally subacute and chronic, the disease could last for years with subtle symptoms and no vegetation on echocardiography, while the bacteria gradually and insidiously destroy the heart valves. We hereby report a young man with Q fever endocarditis with an acute clinical course; in one month, he developed NYHA class IV heart failure, and had a giant 3 cm vegetation on echocardiogram.