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chronic q fever in the united states.infections due to coxiella burnetii, the causative agent of q fever, are uncommon in the united states. cases of chronic q fever are extremely rare and most often manifest as culture-negative endocarditis in patients with underlying valvular heart disease. we describe a 31-year-old farmer from west virginia with a history of congenital heart disease and recurrent fevers for 14 months who was diagnosed with q fever endocarditis based on an extremely high antibody titer against coxiella burnetii p ...200616757641
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