Get answers to your heart disease prevention questions.
Culture-negative endocarditis is an infection and inflammation of the lining of one or more heart valves in which no endocarditis-causing germs can be identified on a blood culture. The reason for this is that certain germs just do not grow well in the laboratory setting, or because some patients have previously received antibiotics that keep such germs from growing.
Endocarditis is usually a result of a blood infection. Bacteria can enter the bloodstream during certain medical procedures, including dental procedures, and travel to the heart, where it can settle on damaged heart valves.
Existing heart disease and problems with your heart valves make you more likely to develop endocarditis. Risk factors include:
Intravenous drug users are also at risk for this condition, because dirty needles can cause bacteria to enter the bloodstream.
However, an organism commonly found in the mouth, Streptococcus viridans, can cause endocarditis. This is why dental procedures increase your chances for developing this condition. Such procedures are especially risky for children with congenital heart conditions. As a result, it is common practice for children with some forms of congenital heart disease and adults with certain heart valve conditions to take antibiotics before any dental work.
An estimated 10,000 to 15,000 new cases of endocarditis are diagnosed each year in the United States.
Fowler VG Jr, Scheld WM, Bayer AS. Endocarditis and Intravascular Infections. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009; chapt 77.
Karchmer AW. Infective Endocarditis. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007:chap 63.
Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007 Oct 9;116(15):1736-54.
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