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Infective Endocarditis pp 245–258Cite as

Blood Culture-Negative Endocarditis

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Abstract

Despite progress in blood culture media and automated growth detection systems, blood culture-negative endocarditis (BCNE) still represents 5–69.7 % of all endocarditis cases. Under the BCNE acronym are grouped diverse clinical entities: (i) the most common are cases of bacterial endocarditis caused by usual pathogens in which the negativity of blood cultures is explained by the early antibiotic treatment started prior to blood sampling; (ii) endocarditis caused by fastidious microorganisms that require prolonged incubation and/or specific media, including Brucella sp., defective streptococci (Abiotrophia sp., Gemella sp.), HACEK bacteria, Propionibacterium acnes, fungi; (iii) endocarditis caused by strictly (Coxiella burnetii, Tropheryma whipplei) or facultative (Bartonella sp.) intracellular bacteria; and (iv) endocarditis that complicate cancers (marantic endocarditis), auto-immune diseases (lupus, Behçet, rheumatoid arthritis) or allergy to pork. Various diagnostic strategies, combining systematic serological, molecular, biochemical and/or histological assays, have improved the diagnostic yield of BCNE but this condition remains challenging.

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Disclosure

P. Tattevin was supported financially by Abbott Laboratories, Astellas, AstraZeneca, Aventis, Bristol-Myers Squibb, Galderma, Gilead Sciences, Janssen-Cilag, MSD, Novartis, Pfizer, and the medicines company ViiV- Healthcare for research, for the organization of scientific meetings, trainings, and/or to attend national and international conferences.

C. Lamas was supported by Novartis Laboratories to attend national and international conferences.

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Authors and Affiliations

  1. Microbiology Laboratory, Institut Hospitalo-Universitaire Méditerranée-Infection, Hospital La Timone, Marseille, France

    Pierre-Edouard Fournier MD, PhD

  2. Department of Internal Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA

    George Watt MD, PhD

  3. Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos

    Paul N. Newton BM, BCh, DPhil, MRCP, DTM&H

  4. Department of Valvular Heart Disease, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil

    Cristiane C. Lamas MD, PhD, MRCP

  5. Intensive Care Unit and Department of Infectious Diseases, Pontchaillou University Hospital, Rennes, France

    Pierre Tattevin MD, PhD

  6. Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UMR CNRS 7278, IRD 198, Institut National de la Santé et de la Recherche Médicale (INSERM) 1095, Faculté de Médecine, Aix-Marseille Université, Marseille, France

    Didier Raoult

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  1. Cardiology Department, Hôpital La Timone, Marseille, France

    Gilbert Habib

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Fournier, PE., Watt, G., Newton, P.N., Lamas, C.C., Tattevin, P., Raoult, D. (2016). Blood Culture-Negative Endocarditis. In: Habib, G. (eds) Infective Endocarditis. Springer, Cham. https://doi.org/10.1007/978-3-319-32432-6_18

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