A Rare Presentation of Q Fever Endocarditis

Q fever endocarditis is caused by the bacteria <i>Coxiella burnetii</i> which primarily spreads via aerosol. It has a higher incidence in males, those with negative blood cultures, animal contact, and preexisting valvular heart disease. Herein, we present an atypical case of culture-negative Q fever endocarditis in a 73-year-old female without a history of valvular heart disease or known animal exposures. Two months prior to this presentation, she was hospitalized for acute hypoxic respiratory failure due to community acquired pneumonia and was recovering well from previous infection until she suddenly developed increased shortness of breath requiring oxygen supplementation, and she was found to have a new murmur during her clinical exam. Her diagnosis of Q fever endocarditis was confirmed, and she required transfer to a tertiary care center for higher level of care. This case stresses the importance of early detection and initiation of treatment through an interdisciplinary approach to reduce the high mortality rates of Q fever endocarditis.