A 39-year-old man with aortic stenosis and regurgitation developed Q fever endocarditis. After 15 weeks of chemotherapy with tetracycline the damaged aortic valve was replaced with a homograft. Organisms were present in the excised valve. Some months later the valve began to leak and the endocarditis recurred fatally. Because of the nature of rickettsial infection neither a course of chemotherapy nor an operation can guarantee a cure of Q fever endocarditis. Chemotherapy should be continued indefinitely even after operation.
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