Open AccessCulture-negative endocarditis: "whatever remains, however improbable, must be the truth"; the importance of asking the right questions!
Author(s) -
Amar Bhavin Kachhia,
Douglas Wan,
Andrew K. Whittaker,
N Shaukat,
Salman Nishtar,
James H. Cullen
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.11.2008.1288
Subject(s) - endocarditis , medicine , mitral valve replacement , blood culture , intensive care medicine , serology , mitral valve , clinical microbiology , fever of unknown origin , general surgery , surgery , immunology , antibiotics , microbiology and biotechnology , antibody , biology
The complicated case of a patient with recurrent culture-negative endocarditis with a history of repeated mitral valve replacement is described. Investigations disqualified common pathology but serology revealed a diagnosis of Q fever endocarditis. The ongoing problematic management of this patient is described, followed by a brief review of the clinical features, investigations and treatment of Q fever.