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- W2158079564 abstract "Background: Blood-culture negative infective endocarditis (BCNIE) is a challenge for clinicians, due in part to the difficult diagnosis and the appropriate choice of antibiotic treatment. Methods: To evaluate clinical findings and long-term outcome of patients (pts) with BCNIE vs pts with positive blood cultures IE (BCPIE) we analize a prospective observational registry of consecutive definitive episodes (ep) of IE according to modified Duke criteria admitted at the institution. Patients follow up was made by patient visits and/or phone calls. The outcome (relapse and reinfection) was evaluated by Kaplan Mayer method. Results: From August 1998 through December 2006, 177 ep. of IE in 169 patients were included. One hundred and thirty four (75,7%) were definitive IE; 32 (23,8%) were BCNIE. Median age 67 y/o (range=16-87); male 25 (78,2%). Previous antibiotic therapy was used in 14/32 ep (43,75%). NVIE 12/32, PVIE 11/32 (5 early) and 9 intracardiac devices. Aortic valve 15, Mitral valve 6, Tricuspid valve 1 and both aortic and mitral valve 1. Clinical picture: fever 25 (78%), sepsis 5 (15,6%), new regurgitation heart murmur 9 (28%). Complications were found in 18/32 patients (56,2%): heart failure 11 (61%), embolic events 6 (75%; 4 were in CNS). Surgery: 24/32 (75%); 13/24 had a positive valve culture or valve PCR. In-hospital mortality: 4/32 (12.5%; 2/24 with surgery). Long-term follow up lasted 1034 days (range 67-3492) and there were 4 relapses (16,5%). The overall mortality was 46,4% (13/28); 8/13 died patients had previous surgery (61,5%). Compared with pts with BCPIE, it was noted that pts with BCNIE more frequently have intracardiac devices (prosthetic valves and pacemakers), surgical treatment and a double rate of mortality in the long-term follow up group. The other variables did not show a statistically significant difference. Conclusion: BCNIE represents a challenge in the clinical practice. It is noteworthy that half of cases had previous antimicrobial therapy; this observation must conscious us about antibiotic use, especially in those patients with intracardiac devices. The mortality and complications makes necessary a lasting and rigorous follow up of pts with BCNIE. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive" @default.
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- W2158079564 date "2010-03-01" @default.
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- W2158079564 title "Blood culture negative infective endocarditis (IE). Clinical features, long- term outcome and comparison with positive blood culture IE" @default.
- W2158079564 doi "https://doi.org/10.1016/j.ijid.2010.02.1622" @default.
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