title: Culture-negative endocarditis: "whatever remains, however improbable, must be the truth"; the importance of asking the right questions!
abstract: 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.
authors.affiliation: Cardiology, Kettering General Hospital NHS Trust, Rothwell Road, Kettering, Northamptonshire, NN16 8UZ, UK.
authors.forename: Amar Bhavin
authors.initials: AB
authors.lastname: Kachhia
authors.forename: Douglas
authors.initials: D
authors.lastname: Wan
authors.forename: Andrew
authors.initials: A
authors.lastname: Whittaker
authors.forename: Naeem
authors.initials: N
authors.lastname: Shaukat
authors.forename: Salman S
authors.initials: SS
authors.lastname: Nishtar
authors.forename: James
authors.initials: J
authors.lastname: Cullen