Infective endocarditis with negative blood cultures

Pesanti, Edward L.; Smith, Ian M.

doi:10.1016/0002-9343(79)90480-7

Cited by 164 publications

(41 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…724,725 Other reasons for negative blood cultures include infections due to Candida; Aspergillus; other fastidious, slow-growing organisms 726 such as Q-fever and Bartonella organisms; and noninfective endocarditis such as LibmanSacks endocarditis in patients with systemic lupus erythematosus. A proposed regimen for culture-negative, presumed bacterial endocarditis 723 is shown in Table 30.…”

Section: Culture-negative Endocarditismentioning

confidence: 99%

2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease

Bonow¹,

Carabello²,

Chatterjee³

et al. 2008

Circulation

910

259

View full text Add to dashboard Cite

Section: Culture-negative Endocarditismentioning

confidence: 99%

2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease

Bonow¹,

Carabello²,

Chatterjee³

et al. 2008

Circulation

910

259

View full text Add to dashboard Cite

“…In a New York series (298), prior administration of antibiotics reduced the incidence of positive blood cultures in patients with documented streptoccocal endocarditis from 97 to 91%. Another study showed that 62% of 52 patients with culture-negative endocarditis had previously received antibiotics compared with only 31% of 84 patients who had positive blood cultures (213). In 1982, Pazin et al reported that 64% of 88 cultures from 17 patients who received antibiotics before hospitalization were positive compared with 100% from 15 patients who had not received antibiotics (210).…”

Section: Strategies For Identification Of the Etiologic Agent Of Infementioning

confidence: 99%

Endocarditis Due to Rare and Fastidious Bacteria

2001

View full text Add to dashboard Cite

The etiologic diagnosis of infective endocarditis is easily made in the presence of continuous bacteremia with gram-positive cocci. However, the blood culture may contain a bacterium rarely associated with endocarditis, such as Lactobacillus spp., Klebsiella spp., or nontoxigenic Corynebacterium, Salmonella, Gemella, Campylobacter, Aeromonas, Yersinia, Nocardia, Pasteurella, Listeria, or Erysipelothrix spp., that requires further investigation to establish the relationship with endocarditis, or the blood culture may be uninformative despite a supportive clinical evaluation. In the latter case, the etiologic agents are either fastidious extracellular or intracellular bacteria. Fastidious extracellular bacteria such as Abiotrophia, HACEK group bacteria, Clostridium, Brucella, Legionella, Mycobacterium, and Bartonella spp. need supplemented media, prolonged incubation time, and special culture conditions. Intracellular bacteria such as Coxiella burnetii cannot be isolated routinely. The two most prevalent etiologic agents of culture-negative endocarditis are C. burnetti and Bartonella spp. Their diagnosis is usually carried out serologically. A systemic pathologic examination of excised heart valves including periodic acid-Schiff (PAS) staining and molecular methods has allowed the identification of Whipple's bacillus endocarditis. Pathologic examination of the valve using special staining, such as Warthin-Starry, Gimenez, and PAS, and broad-spectrum PCR should be performed systematically when no etiologic diagnosis is evident through routine laboratory evaluation

show abstract

“…In one study of culture-negative IE, 62% of the patients had a history of prior antibiotic treatment before blood cultures were drawn. 21 Those patients need close observation for other supporting evidence of IE. Transthoracic echocardiography might be helpful in this group in documenting evidence of endocardial involvement.…”

Section: Commentmentioning

confidence: 99%