© 2003 by BMJ Publishing Group & British Cardiac Society
EDITORIAL
Diagnosis of culture negative endocarditis: novel strategies to prove the suspect guilty
Klinik für Kardiologie, Universitätsklinikum Essen, Germany
Correspondence to:
Correspondence to:
Dr Christoph K Naber, Klinik für Kardiologie, Universitätsklinikum Essen, Hufelandstrasser 55, 45122 Essen, Germany;
Christoph.naber@medizin.uni-essen.de
Negative blood cultures can occur in up to a third of all cases of infective endocarditis, which often delays diagnosis and onset of treatment with profound impact on the clinical outcome. Thus novel strategies for the identification of culture negative cases are highly desirable
Keywords: Duke criteria; culture negative endocarditis; endocarditis
| The first 150 words of the full text of this article appear below. |
The diagnosis of infective endocarditis with its multiple clinical and morphological manifestations remains a challenging task. The von Reyn criteria, published in 1981, focused mainly on clinical and pathological findings in combination with positive blood culture to diagnose infective endocarditis.1 They were helpful to standardise diagnostic criteria, but their positive and negative predictive values remained unacceptably low, especially in the absence of positive blood culture results. With the introduction of transoesophageal echocardiography for the diagnosis of infective endocarditis,2 and the implementation of this method into the diagnostic criteria by Durack and colleagues,3 sensitivity and specificity of the diagnosis was significantly increased.4 Yet, in culture negative cases, sensitivity of these Duke criteria remains limited.5,6
In most cases, there are two reasons for negative blood cultures: (1) patients received antibiotics before blood cultures are taken due to systemic infection or suspected diagnosis of a bacterial infection; and (2) the causative microorganisms have
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Todd, A.J., Leslie, S.J., MacDougall, M., Denvir, M.A.
(2006). Clinical features remain important for the diagnosis of infective endocarditis in the modern era. QJM
99: 23-31
[Abstract] [Full Text] -
Vassalos, A., Dancer, S.J., MacArthur, K.J.D.
(2004). Polymerase chain reaction diagnosis in culture-negative prosthetic valve methicillin-resistant Staphylococcus aureus endocarditis in a patient with chronic liver disease. ICVTS
3: 240-242
[Abstract] [Full Text] -
Prendergast, B D
(2004). Diagnostic criteria and problems in infective endocarditis. Heart
90: 611-613
[Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
-
Drugs: cardiovascular system
-
Echocardiography
-
Clinical diagnostic tests
-
Aortic valve disease
-
Mitral valve disease
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
