title: 'Culture-negative' prosthetic valve endocarditis. Hazards of postoperative steroid therapy for unexplained fever.
abstract: Two patients had prolonged unexplained fever along with multiple negative blood cultures after cardiac valve replacement surgery. Following the administration of corticosteroids for presumed postpericardiotomy syndrome, both patients improved symptomatically and defervesced, only to have positive blood cultures for Staphylococcus epidermidis shortly thereafter. The theoretical and practical risks of the empiric use of anti-inflammatory agents for unexplained post-operative fever are reviewed. "Culture-negative" prosthetic valvular infection due to prior antibiotic prophylaxis or therapy must be strongly considered in the evaluation of such unexplained fever.
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D004697:Endocarditis, Bacterial / Q000209:etiology* / Q000382:microbiology; D005188:False Negative Reactions; D005260:Female; D005334:Fever / Q000188:drug therapy* / Q000209:etiology; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011185:Postpericardiotomy Syndrome / Q000188:drug therapy
chemical_list: D000305:Adrenal Cortex Hormones