Gold Coast University Hospital, Southport, QLD, Australia.
School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia.
Infection. 2023 Dec;51(6):1629-1631. doi: 10.1007/s15010-023-02097-6. Epub 2023 Oct 4.
Infective endocarditis is a common cardiac condition, with significant mortality. Blood culture-negative endocarditis is an important subgroup of endocarditis that holds significant morbidity and mortality.
We performed an updated review of the literature. We searched the databases of Web of Science, MEDLINE, EMBAS and Scopus for the latest clinical guidelines and literature on blood culture negative endocarditis to provide a narrative synthesis of the literature.
There is significant heterogeneity in causes and complications of culture-negative infective endocarditis, due to an insensitivity in available clinical diagnostic pathways. Despite significant advances in diagnostic tools, the diagnostic criterion for infective endocarditis (the modified Duke's criterion) remains insensitive to the detection of culture-negative infective endocarditis.
The natural history of BCNE and our diagnostic resources are changing. It is time our criterion did too. Remembering, BCNE holds significant morbidity and mortality-the absence of organism of culture should not reassure, rather concern clinicians. Every effort should be made to accurately identify organisms.
感染性心内膜炎是一种常见的心脏疾病，死亡率较高。血培养阴性心内膜炎是心内膜炎的一个重要亚组，具有较高的发病率和死亡率。
我们对文献进行了最新的回顾。我们在 Web of Science、MEDLINE、EMBASE 和 Scopus 数据库中搜索了有关血培养阴性心内膜炎的最新临床指南和文献，对文献进行了叙述性综合分析。
由于现有临床诊断途径的不敏感性，导致血培养阴性感染性心内膜炎的病因和并发症存在显著异质性。尽管诊断工具取得了重大进展，但感染性心内膜炎的诊断标准（改良的杜克标准）对血培养阴性感染性心内膜炎的检测仍然不敏感。
BCNE 的自然病史和我们的诊断资源正在发生变化。我们的标准也应该改变了。需要记住的是，BCNE 具有较高的发病率和死亡率——培养物中没有发现病原体不应让人安心，而应引起临床医生的关注。应尽一切努力准确识别病原体。
