Chronic q fever: 2. Morbid anatomical and bacteriological findings in a patient with endocarditis

Abstract

This paper describes the pathological and bacteriological findings in the case of chronic Q fever infection described clinically by Robson and Shimmin. Examination of the patient's serum at the beginning of his chronic illness revealed high titres of complement- fixing antibody to both antigenic phases of Rickettsia burnecti. The rickettsia was isolated from the blood stream on two widely separated occasions during the chronic illness. An account of the experiments establishing these points is given in detail. Examination after death revealed a cerebral haemorrhage, a distorted aortic valve with vegetations, and various secondary changes in other organs resulting from heart failure. Microcolonies of rickettsia-like organisms were seen in histological sections of the aorticvalve vegetations, which were also shown by guinea-pig inoculation to contain R. burnedi in large numbers. In addition, the rickettsia was isolated from the lung and spleen. The findings differed in a number of ways from those of subacute bacterial endocarditis, and this point is explored in detail. © 1959, British Medical Journal Publishing Group. All rights reserved.