This commentary, based on the paper by Buijs et al. [1] in the current issue of CMI, discusses the importance of monitoring serological titre changes in patients with chronic Q fever. The authors evaluated phase I IgG dynamics and the association with Q fever complications and therapy failure. Contrary to common perceptions, they found no association between antibody dynamics during the patient follow-up period and various clinical outcomes. These findings challenge current practice, which puts considerable value on serological changes while monitoring the patient's response to therapy in chronic Q fever.