Q Fever Endocarditis: A Challenging Diagnosis in a Patient Referring Weight Loss and Anorexia, and With Granulomas in Gastric Biopsy Specimens.

Diagnosis of Q fever endocarditis is challenging since clinical findings are non-specific and diagnosis is mainly made by indirect methods such as serology. A progressive constitutional syndrome, severe asthenia, anorexia with no fever and histopathological findings of non-necrotizing gastric granulomas in a gastric biopsy were found preceding a cardiac failure in our case report. Prolonged treatment with doxycycline and hydroxychloroquine is mandatory, and cardiac valve surgery may be needed.