burnetii in community-acquired, culture-negative endocarditis
may be clinically useful, particularly in screening for B.
The modified Duke diagnostic criteria are heavily based upon positive blood cultures, and a low microbiologic yield from blood culture raises questions as to the validity of these criteria in diagnosing culture-negative endocarditis in developing countries.
Second, only 20 patients (13%) underwent transesophageal echocardiography; the prevalence of culture-negative endocarditis may have increased if TEE had been performed on all patients.
Culture-negative endocarditis continues to have a high prevalence in developing countries like Pakistan, largely due to prior antibiotic use before clinical presentation.
Because 16S rRNA PCR is used in many areas to test for blood culture-negative endocarditis, which would enable detection of T.
In the future, blood specimens from patients with blood culture-negative endocarditis should be also inoculated systematically on specific media.
The difference in comparison to other countries is that blood culture-negative endocarditis is mainly linked to zoonotic and arthropodborne agents.
Of the 62 blood culture-negative endocarditis cases, samples from all were tested by serologic or molecular methods.
According to the earliest published report on the subject, the prevalence of blood culture-negative endocarditis
once ranged from 2.
Of 66 sera taken from cases of culture-negative endocarditis
and sent to the Public Health Laboratory Service in London, United Kingdom, 18% were positive for Bartonella antibodies (8).