• Julius Steffen, Johannes Bogner, and Bruno C Huber.
• Medizinische Klinik und Poliklinik I, Klinikum der Universität München.
• Dtsch. Med. Wochenschr. 2020 Apr 1; 145 (7): 484-487.

Patient HistoryA 33-year old Romanian chef presented with sudden onset of chest pain and chills as well as a significant elevation of myocardial markers and CRP.ExamsCoronary angiography showed no signs of relevant atherosclerosis. A myocarditis was assumed and later diagnosed on cardiac MRI.DiagnosticsDue to fevers up to 40 °C and occupational history, Q fever was assumed. Serologic findings confirmed the diagnosis.Therapy And Course Of EventsAfter the start of antibiotic treatment, temperatures remained normal and the patient could be discharged a few days later. Azithromycin was recommended for several weeks to prevent a chronic infection. At the check-up visit one month later the patient appeared to have no signs of chronic heart failure or persistent infection.ConclusionsMyocarditis is a rare manifestation of Q fever, which should not be missed. The diagnostic evaluation with antibody titers is easy. The antibiotic therapy is well tolerated and is a causal treatment that helps to prevent long-term damage.© Georg Thieme Verlag KG Stuttgart · New York.

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