Mixed cryoglobulinemia associated with chronic Q-fever.

A 41-year-old woman who presented with purpura, glomerulonephritis and mixed cryoglobulinemia was found subsequently to have developed chronic Q-fever. Since Q-fever is a frequent cause of culture negative endocarditis in some endemic areas, the diagnosis of Q-fever endocarditis should be considered in patients presenting with mixed cryoglobulinemia of unknown cause.