title: Reassessment of blood culture-negative endocarditis: its profile is similar to that of blood culture-positive endocarditis.
abstract: OBJECTIVE
  Left-sided infective endocarditis with blood culture-negative has been associated with delayed diagnosis, a greater number of in-hospital complications and need for surgery, and consequently worse prognosis. The aim of our study was to review the current situation of culture-negative infective endocarditis.
  
  
  METHODS
  We analyzed 749 consecutive cases of left-sided infective endocarditis, in 3 tertiary hospitals from June 1996 to 2011 and divided them into 2 groups: group I (n=106), blood culture-negative episodes, and group II (n=643) blood culture-positive episodes. We used Duke criteria for diagnosis until 2002, and its modified version by Li et al. thereafter.
  
  
  RESULTS
  Age, sex, and comorbidity were similar in both groups. No differences were found in the proportion of patients who received antibiotic treatment before blood culture extraction between the 2 groups. The interval from symptom onset to diagnosis was similar in the 2 groups. The clinical course of both groups during hospitalization was similar. There were no differences in the development of heart failure, renal failure, or septic shock. The need for surgery (57.5% vs 55.5%; P=.697) and mortality (25.5% vs 30.6%; P=.282) were similar in the 2 groups.
  
  
  CONCLUSIONS
  Currently, previous antibiotic therapy is no longer more prevalent in patients with blood culture-negative endocarditis. This entity does not imply a delayed diagnosis and worse prognosis compared with blood culture-positive endocarditis. In-hospital clinical course, the need for surgery and mortality are similar to those in patients with blood culture-positive endocarditis. Full English text available from:www.revespcardiol.org.
authors: Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, España. carlosferreraduran@gmail.com
authors: Carlos
authors: C
authors: Ferrera
authors: Isidre
authors: I
authors: Vilacosta
authors: Cristina
authors: C
authors: Fernández
authors: Javier
authors: J
authors: López
authors: Carmen
authors: C
authors: Olmos
authors: Cristina
authors: C
authors: Sarriá
authors: Ana
authors: A
authors: Revilla
authors: David
authors: D
authors: Vivas
authors: Carmen
authors: C
authors: Sáez
authors: Enrique
authors: E
authors: Rodríguez
authors: José Alberto
authors: JA
authors: San Román
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015331:Cohort Studies; D015897:Comorbidity; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents