QJM Advance Access originally published online on October 3, 2008
QJM 2009 102(1):63-65; doi:10.1093/qjmed/hcn118
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Urban trench fever presenting as culture-negative endocarditis
From the 1Department of Infectious Diseases and Microbiology, 2Nuffield Department of Pathology, 3Department of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford and 4Respiratory & Systemic Infection Laboratory, HPA Centre for Infections, London, UK
Address correspondence to N.E. Jenkins, Department of Infectious Diseases and Microbiology, John Radcliffe Hospital, Oxford, Oxon OX3 9DU, UK. email: njenkins{at}liv.ac.uk
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A young Russian man presented with increasing shortness of breath and signs of worsening aortic regurgitation. A diagnosis of infective endocarditis was made before emergency valve replacement. The infective cause was not discovered by routine culture but was suggested by electron microscopy and confirmed by serology and PCR testing.