A Comparison of Culture-Negative and Culture-Positive Endocarditis

Clinical Takeaway

: Culture-negative cases manifest differently from culture-positive ones and may be less common than previously thought.

Context

Culture-negative infective endocarditis (IE) is a longstanding clinical challenge, but little is known about its prevalence and presentation in the current era of diagnostic microbiology. To address this gap, researchers evaluated a national registry of all IE cases in Denmark from 2016 through 2021, focusing on the nearly 3000 adults with a first-time left-sided IE.

Key Results

Roughly 7% of cases were culture negative, defined by the absence of bacterial pathogens on blood culture, valve tissue culture, or PCR analysis.
Culture-negative IE manifested differently from culture-positive disease, with less frequent fever and sepsis but more embolic complications and valvular insufficiency ().
No significant mortality differences we…

Reviewing Author

George Sakoulas, M.D.

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases