Afebrile Blood Culture–Negative Endocarditis
Authors: Didier Raoult
Journal: Annals of Internal Medicine (1999)

Editorials20 July 1999Afebrile Blood Culture–Negative EndocarditisDidier Raoult, MD, PhDDidier Raoult, MD, PhDUniversité de la Méditerranée; 13385 Marseille, France (Raoult)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-2-199907200-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Fever, positive blood culture, and the presence of valvular vegetation on echocardiography are the usual indicators of infective endocarditis. If a patient does not have a fever, however, clinicians frequently do not consider this diagnosis. In such cases, diagnosis may be delayed until hemodynamic compromise necessitates valve replacement, as in the case of Coxiella burnetii infective endocarditis (1) and the report by Gubler and colleagues (2) in this issue.Clinicians usually diagnose infective endocarditis by using the Duke criteria (3), which include two major criteria (blood cultures typical of infective endocarditis and vegetations on findings on echocardiography) and seven minor ...References1. Brouqui P, Tissot Dupont H, Drancourt M, Berland Y, Etienne J, Leport C, et al . Chronic Q fever. Ninety-two cases from France, including 27 cases without endocarditis. Arch Intern Med. 1993;153:642-8. CrossrefMedlineGoogle Scholar2. Gubler JG, Kuster M, Dutly F, Bannwart F, Krause M, Vögelin HP, et al . Whipple endocarditis without overt gastrointestinal disease: report of four cases. Ann Intern Med. 1999;131:112-6. LinkGoogle Scholar3. Durack DT, Lukes AS, Bright DK. 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Raoult D, Fournier PE, Drancourt M, Marrie TJ, Etienne J, Cosserat J, et al . Diagnosis of 22 new cases of Bartonella endocarditis. Ann Intern Med. 1996;125:646-52. LinkGoogle Scholar18. Lowsky R, Archer GL, Fyles G, Minden M, Curtis J, Messner H, et al . Brief report: diagnosis of Whipple's disease by molecular analysis of peripheral blood. N Engl J Med. 1994;331:1343-6. CrossrefMedlineGoogle Scholar19. Maiwald M, Schuhmacher F, Ditton HJ, von Herbay A. Environmental occurrence of the Whipple's disease bacterium (Tropheryma whippelii). Appl Environ Microbiol. 1998;64:760-2. CrossrefMedlineGoogle Scholar20. Schoedon G, Goldenberger D, Forrer R, Gunz A, Dutly F, Hochli M, et al . Deactivation of macrophages with interleukin-4 is the key to the isolation of Tropheryma whippelii . J Infect Dis. 1997;176:672-7. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Didier Raoult, MD, PhDAffiliations: Université de la Méditerranée; 13385 Marseille, France (Raoult)Corresponding Author: Didier Raoult, MD, PhD, Unité des Rickettsies, Cnrs Upresa 6020, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille cedex 05, France. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoWhipple Endocarditis without Overt Gastrointestinal Disease: Report of Four Cases Jacques G.H. Gubler , Marcel Kuster , Fabrizio Dutly , Fridolin Bannwart , Martin Krause , Hans Peter Vögelin , Gianni Garzoli , and Martin Altwegg Whipple Endocarditis without Gastrointestinal Disease Margo A. 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Smith, MDProposed Modifications to the Duke Criteria for the Diagnosis of Infective Endocarditis 20 July 1999Volume 131, Issue 2Page: 144-146KeywordsBacteriaBartonellaBloodDNAEchocardiographyEndocarditisHeart diseasesLesionsPeriodic acid SchiffStaining ePublished: 15 August 2000 Issue Published: 20 July 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...