title: Chronic Q fever endocarditis.
abstract: Eight patients with chronic Q fever endocarditis were treated with tetracycline for up to 40 months. In addition, five of these patients received co-trimoxazole. Six patients had prosthetic valves. Two patients who had Q fever endocarditis on their native valves required valve replacement because of haemodynamic difficulties: in only one did the Q fever endocarditis contribute to the haemodynamic difficulty. One patient died. It is suggested that medical treatment is continued until clinically and haematologically there is no evidence of endocarditis and the Q fever phase 1 antibody titre is less than 200. No recurrence of Q fever endocarditis has been detected in three of our patients who have now stopped treatment.
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000032:analysis; D002908:Chronic Disease; D003381:Coxiella / Q000276:immunology; D004338:Drug Combinations; D004697:Endocarditis, Bacterial / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011778:Q Fever / Q000188:drug therapy* / Q000276:immunology / Q000601:surgery; D013420:Sulfamethoxazole / Q000627:therapeutic use; D013752:Tetracycline / Q000627:therapeutic use; D014295:Trimethoprim / Q000627:therapeutic use
chemical_list: D000907:Antibodies, Bacterial; D004338:Drug Combinations; D014295:Trimethoprim; D013752:Tetracycline; D013420:Sulfamethoxazole