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Current Cardiology Reviews


ISSN (Print): 1573-403X
ISSN (Online): 1875-6557

Case Report

Case Report: Culture-negative Prosthetic Valve Endocarditis

Author(s): Ignacio D. Velazquez*, Kenneth K. Woo, Mohammed Siddiqui and Sion K. Roy

Volume 19, Issue 6, 2023

Published on: 25 May, 2023

Article ID: e110423215668 Pages: 4

DOI: 10.2174/1573403X19666230411151214

Price: $65


Background: Prosthetic valve endocarditis can be difficult to diagnose and cause significant morbidity and mortality, especially when no culture data are available to guide therapy. Transthoracic and transesophageal echocardiograms, the studies of choice for initial endocarditis evaluation, can be less reliable due to artifact and post-surgical changes. Some less common forms of endocarditis may be difficult to culture and, due to their fastidious nature, may delay the identification of causative organisms. Given the lack of directed antimicrobial treatment, culturenegative prosthetic valve endocarditis is specifically difficult. A wide differential diagnosis is critical to make a timely diagnosis and initiate treatment.

Case Presentation: We present a case of a patient presenting with dyspnea which was found to have culture-negative endocarditis requiring mitral and aortic valve replacement that ultimately was complicated with culture-negative prosthetic valve endocarditis. Identifying a culprit organism made appropriate and timely antimicrobial treatment difficult, ultimately resulting in the patient dying from endocarditis complications.

Conclusion: A high index of suspicion is needed when managing infective endocarditis, especially when prosthetic valves are involved. Diagnostic accuracy of cultures and echocardiography may be reduced when dealing with prosthetic valve endocarditis; thus, alternative methods of diagnosis may be required to make a timely diagnosis of causative organisms.

Keywords: Fungal endocarditis, aspergillus endocarditis, prosthetic valve endocarditis, culture-negative infective endocarditis, transesophageal echocardiograms, treatment.

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