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Clinical, virological, and pathological findings in a fatal case of Q fever endocarditis
  1. I. C. Ferguson,
  2. J. E. Craik,
  3. N. R. Grist
  1. Medical Unit and Department of Pathology, Victoria Infirmary, Glasgow
  2. University Department of Virology, Ruchill Hospital, Glasgow

    Abstract

    A case resembling subacute bacterial endocarditis in which blood cultures were repeatedly negative is described. The patient had had an influenza-like illness nine months before admission to hospital followed by intervening vague illness and loss of weight.

    Serological tests revealed a high titre of complement-fixing antibodies to phase 1 and phase 2 antigens of Rickettsia burneti. After death R. burneti was isolated from the diseased aortic valve, liver, and kidneys.

    Bodies morphologically resembling rickettsiae were seen in the aortic valve and in a very few renal tubule cells. No specific pathological lesions were found but there was a widespread stimulation of reticulo-endothelial cells particularly in the aortic valve cusps, spleen, lymph nodes, and renal glomeruli.

    It is suggested that tests for Q fever should be carried out in suspected cases of subacute bacterial endocarditis when blood culture is negative.

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