Chronic Q fever: expert opinion versus literature analysis and consensus.

Q fever has long been considered a rare disease. The extensive outbreak in the Netherlands generated a body of literature based solely on the consensus in the Netherlands. As a long-standing expert on Q fever, I offer my experience and recommendations to the E-CDC and the Dutch Q fever Consensus Group. My (biased) opinion is that experts deeply involved in the field continue to be useful in the management of outbreaks and can avoid decisions that produce an unfavorable progression in patients. Here, I propose that the definition of "chronic Q fever" be avoided and suggest a new score-based diagnosis for Q fever endocarditis and vascular infection.