Culture-negative endocarditis

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Culture-negative endocarditis

Endocarditis (culture-negative)

Fever, extreme fatigue and breathing difficulty are common symptoms of endocarditis.

Signs of endocarditis include:

• Tachycardia (fast heart rate)
• Fever
• A new heart murmur on cardiac exam

The following tests may be requested:

• An ECG and a chest x-ray
• A complete blood count (CBC)
• Blood cultures: when certain bacteria called fastidious organisms (Bartonella, Coxiella, Mycobacterium, and germs of the HACEK group) cause the endocarditis, cultures may not grow germs. The identification of responsible germs must then be done with special culture conditions and prolonged incubation time. Often, the diagnosis can only be made based on antibody or DNA studies.
• An echocardiogram to picture the valves of the heart, to visualize any vegetations, and to evaluate heart function
• A transesophageal echocardiogram (TEE), a special echocardiogram done by introducing a small probe into the patient's mouth and down the esophagus

Review Date: 05/26/2006
Reviewed By: Monica Gandhi MD, MPH, Assistant Professor, Division of Infectious Diseases, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.