# Atypical Presentation of Coxiella burnetii Endocarditis: Diagnostic Considerations and the Importance of Keeping a Broad Differential

## TL;DR

This paper discusses a rare case of Coxiella burnetii endocarditis with unusual symptoms and no typical risk factors, highlighting the need for broad diagnostic approaches.

## Contribution

The novelty lies in presenting an atypical case lacking traditional risk factors and meeting no Duke criteria for endocarditis.

## Key findings

- The patient had Coxiella burnetii endocarditis without typical risk factors like farm animal exposure.
- Standard diagnostic criteria and initial tests failed to identify the infection.
- The case emphasizes the importance of considering rare pathogens in endocarditis diagnosis.

## Abstract

Coxiella burnetii is a gram-negative bacterium associated with serious complications such as infective endocarditis. Early diagnosis and treatment can be difficult due to its nonspecific presentation and risk factors that include contact with farm animals or their byproducts. Here, we present an atypical presentation of infective endocarditis caused by Coxiella burnetii, where the patient had no risk factors, negative Duke criteria, and negative preliminary workup.