Culture-Negative IE in the Modern Diagnostic Era: Patient Characteristics and Heterogeneity in a Nationwide Cohort - PubMed
10 hours ago
- #clinical epidemiology
- #culture-negative
- #infective endocarditis
- The study provides a detailed characterization of culture-negative infective endocarditis (CNIE) using a nationwide Danish cohort from 2016 to 2021.
- Among 2,875 IE patients, 212 (7.4%) had CNIE, which is lower than previously reported.
- CNIE patients were more likely to have congenital heart disease and less likely to have previous cancer compared to culture-positive IE (CPIE) patients.
- Clinical presentation differed: CNIE patients had less fever and sepsis but higher rates of embolism and valvular insufficiency.
- Vegetations were smaller in CNIE (median 8 mm vs. 10 mm), while prosthetic valve infection and valve surgery rates were similar.
- PET-CT was commonly used and diagnostic, with a yield of almost 50% in prosthetic valve CNIE cases.
- CNIE is heterogeneous and should be defined by distinct subgroups rather than a single phenotype.