We report a case of a patient with an aortic prosthetic valve who had Q fever endocarditis, glomerulonephritis and rapidly progressive renal failure. He was seen in 1987 and successfully treated by heart valve surgery and a one-year course of doxycycline. Five years later, the patient had another episode of Q fever endocarditis, involving the native mitral valve, complicated with acute renal failure and severe mitral regurgitation that required hemodialysis and mitral valve replacement. The outcome was again successful. This case report raises the question of whether Q fever endocarditis can be eradicated, and also the required duration of antibiotic therapy for this disease.