I am an Returned Service League of Australia (RSL) Advocate working for free for ex service clientele trying to obtain their correct entitlements from the Government. I have a client who was a soldier and has recently had his aortic valve replaced. He contracted Q fever whilst in the tropics of Queensland after pig hunting (adventure training). Can Q fever cause the eventual replacement of the aortic valve?? Would infective endocarditis be a likely vehicle for infection?

Q fever is a rare disease caused by inhalation of Coxiella burnetii bacterial spores which may be found in the droppings of livestock such as cattle and sheep but has been know known to be contracted from dogs, cats, and pigs as well. The bacterial spores are often inhaled and Q fever mainly affects the lungs. The spores usually take a few weeks to grow and replicate after which infected patients begin to experience high fever flu-like symptoms often accompanied by diarrhea. Rarely can Q fever affect the liver and eyes.

Chronic Q fever most often presents as endocarditis especially in patients with pre-existing conditions such as heart valve defects or immunocompromed patients. Patients may present with nonspecific symptoms or fulminate heart failure. Death from chronic Q fever endocarditis has been reported as 50-70%. Aortic valves and mitral valves are the most commonly affected in the heart and if the disease is undiagnosed initially, the patient may need a valve replacement.

Therefore, to answer your question, yes, chronic Q fever is a well documented cause of endocarditis and one of the most common valves affected by the disease is the aortic valve.