Blood culture-negative infective endocarditis: are we looking hard enough?

Introduction Infective endocarditis is a common cardiac condition, with significant mortality. Blood culture-negative endocarditis is an important subgroup of endocarditis that holds significant morbidity and mortality. Method We performed an updated review of the literature. We searched the databas...

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Bibliographic Details
Published in:Infection 2023-12, Vol.51 (6), p.1629-1631
Main Authors: Kirk, Frazer, Vaselli, Natasha Marcella
Format: Article
Language:English
Subjects:
Blood
Blood culture
Criteria
Culture
Endocarditis
Family Medicine
General Practice
Heterogeneity
Infectious Diseases
Internal Medicine
Literature reviews
Medicine
Medicine & Public Health
Morbidity
Mortality
Review
Subgroups
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Summary:Introduction Infective endocarditis is a common cardiac condition, with significant mortality. Blood culture-negative endocarditis is an important subgroup of endocarditis that holds significant morbidity and mortality. Method We performed an updated review of the literature. We searched the databases of Web of Science, MEDLINE, EMBAS and Scopus for the latest clinical guidelines and literature on blood culture negative endocarditis to provide a narrative synthesis of the literature. Results There is significant heterogeneity in causes and complications of culture-negative infective endocarditis, due to an insensitivity in available clinical diagnostic pathways. Despite significant advances in diagnostic tools, the diagnostic criterion for infective endocarditis (the modified Duke’s criterion) remains insensitive to the detection of culture-negative infective endocarditis. Conclusion The natural history of BCNE and our diagnostic resources are changing. It is time our criterion did too. Remembering, BCNE holds significant morbidity and mortality—the absence of organism of culture should not reassure, rather concern clinicians. Every effort should be made to accurately identify organisms.
ISSN:0300-8126
1439-0973
DOI:10.1007/s15010-023-02097-6