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Chronic Q fever infections, caused by Coxiella burnetii, are associated with cardiovascular complications, mainly endocarditis and vascular (graft) infections. We report a case of a patient with a C. burnetii infected thoracic aorta graft treated initially in a conservative way. However, surgical excision of the infected graft was eventually necessary. This case report highlights the challenges regarding the treatment of patients with chronic vascular C. burnetii infections. In the absence of practical guidelines, treatment is tailored to the individual patient. Furthermore, we want to emphasize the need to include chronic Q fever in the differential diagnosis in patients with culture negative aortitis, especially in the regions with Q fever epidemics in the recent past.

David procedure during a reoperation for ongoing chronic Q fever infection of an ascending aortic prosthesis