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Infections due to Coxiella burnetii, the causative organism of Q fever, are extremely rare in North America. Endocarditis due to the organism has an unusual presentation and poses echocardiographic and laboratory challenges in establishing a diagnosis. We describe the presentation and clinical course of a 40-year-old American man with Q fever endocarditis and briefly discuss the salient issues regarding this entity.

As an increasing number and variety of prosthetic devices are used in cardiovascular medicine, novel infectious complications have been described. Infection of intra-arterial devices, including arterial closure devices, prosthetic carotid patches, coronary artery stents and endovascular stents, and stent-grafts, is now being reported. Prosthetic vascular graft infection is an older, more common, and better-characterized entity, but recent developments in the surgical management of these infections have prompted a re-examination of the syndrome. Staphylococcal species account for most intra-arterial device infections, and often, morbidity and mortality rates are high. An update on intra-arterial device infections is warranted.

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