Tsujihata Tomoo, Nagano Hiroyuki, Sada Ryuichi M, Iwai-Kanai Eri, Hatta Kazuhiro
Department of General Internal Medicine, Tenri Hospital, Tenri, JPN.
Department of Transformative Protection to Infectious Disease, Graduate School of Medicine, Osaka University, Osaka, JPN.
Cureus. 2025 Jul 18;17(7):e88226. doi: 10.7759/cureus.88226. eCollection 2025 Jul.
We report a case of culture-negative infective endocarditis in a 64-year-old hemodialysis patient who presented with fever and dyspnea. Despite empirical antibiotic therapy and negative blood cultures, transesophageal echocardiography later revealed aortic valve vegetation and destruction. The patient developed cardiogenic shock and died before surgery. This case illustrates the diagnostic challenges of culture-negative infective endocarditis, especially in high-risk populations. Early blood culture collection and continuous reassessment of surgical timing are crucial to improve outcomes.
我们报告了一例64岁血液透析患者的血培养阴性感染性心内膜炎病例，该患者出现发热和呼吸困难。尽管进行了经验性抗生素治疗且血培养结果为阴性，但经食管超声心动图后来显示主动脉瓣有赘生物和破坏。患者发展为心源性休克，在手术前死亡。该病例说明了血培养阴性感染性心内膜炎的诊断挑战，尤其是在高危人群中。早期采集血培养以及持续重新评估手术时机对于改善预后至关重要。
