[Current status of the Q-rickettsial endocarditis problem and the 1st case reported in Bulgaria]

A vast literary review on Q-rickettsial endocarditis is presented--spread, frequency, predilection, clinical course, laboratory findings, diagnosis, treatment, prognosis. The first case of Q-rickettsial endocarditis in Bulgaria is reported. The case was proved by the high titre of the specific antibodies while the patient was still alive and post mortem by visualizing the causative agent in the aortic valve and by its isolation through inoculation of material from the aortic valve. The infection was not influenced by high doses of penicillin, gentamycin and brulamycin but was suppressed by vibramycin in combination with lincomycin and biseptol. The lethal outcome was due to severe heart failure. It is suggested that other cases of Q-rickettsial endocarditis should be expected since Q-fever is widely spread in Bulgaria and the characteristics of the disease, its diagnosis and treatment ought to be well known.