Chronic Q fever with mixed cryoglobulinaemia.

A 47 year old woman presented with a six month history of vasculitic rash, splenomegaly, and cardiac murmurs. Investigations showed the presence of mixed cryoglobulinaemia and raised titres to Coxiella burnetii consistent with chronic Q fever infection. The patient was treated with tetracycline (1 g four times a day).