title: Infective endocarditis with negative blood culture and negative echocardiographic findings.
abstract: A 61-year-old male presented with fever. He had a history of aortic valve replacement, and infective endocarditis was suspected. The transthoracic and transesophageal echocardiography on admission could not detect vegetation, and all blood cultures obtained were negative. We concluded that infective endocarditis was not likely. However, repeated echocardiography revealed paravalvular regurgitation and paravalvular abscess. Serum antibody testing for Bartonella henselae was positive, leading to the diagnosis of blood culture-negative endocarditis. Even when blood cultures and echocardiography were negative on initial examination, careful history-taking, blood tests accounting for these pathogens, and repeated echocardiography are crucial for diagnosis.
authors.affiliation: Department of Laboratory Medicine, Kameda Medical Center, 929 Higashicho, Kamogawa, Japan.
authors.forename: Izumi
authors.initials: I
authors.lastname: Sumatani
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kagiyama
authors.forename: Chie
authors.initials: C
authors.lastname: Saito
authors.forename: Masaki
authors.initials: M
authors.lastname: Makanae
authors.forename: Hideo
authors.initials: H
authors.lastname: Kanetsuna
authors.forename: Kenta
authors.initials: K
authors.lastname: Ahn
authors.forename: Akira
authors.initials: A
authors.lastname: Mizukami
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hashimoto
mesh_terms: D016917:Angiomatosis, Bacillary / Q000175:diagnosis*; D001021:Aortic Valve; D018416:Bartonella henselae; D000071997:Blood Culture; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged