0175: Reassessment of blood culture-negative endocarditis: its profile is similar to that of blood culture-positive endocarditis

Introduction and objectivesLeft-sided infective endocarditis with blood culture-negative has been associated with delayed diagnosis, a greater number of in-hospital complications and need for surgery, and consequently worse prognosis. The aim of our study was to review the current situation of culture negative infective endocarditis.MethodsWe analyzed 439 consecutive cases of left-sided infective endocarditis, in 3 Algerian hospitals from Juanuary 2006 to 2011 and divided them into 2 groups: group I (n=62), blood culture-negative episodes, and group II (n=377) blood culture-positive episodes. We used Duke criteria for diagnosis.ResultsAge, sex, and comorbidity were similar in both groups. No differences were found in the proportion of patients who received antibiotic treatment before blood culture extraction between the 2 groups. The interval from symptom onset to diagnosis was similar in the 2 groups. The clinical course of both groups during hospitalization was similar. There were no differences in the development of heart failure, renal failure, or septic shock. The need for surgery (57.5% vs 55.5%; P=.697) and mortality (25.5% vs 30.6%; P=.282) were similar in the 2 groups.ConclusionsCurrently, previous antibiotic therapy is no longer more prevalent in patients with blood culture-negative endocarditis. This entity does not imply a delayed diagnosis and worse prognosis compared with blood culture-positive endocarditis. In-hospital clinical course, the need for surgery and mortality are similar to those in patients with blood culture-positive endocarditis