1887

Abstract

Introduction:

Prior studies (predominantly from Europe) have demonstrated blood culture-negative endocarditis due to . Our objective was to describe three cases of endocarditis identified within one year at a large hospital in Washington, DC, USA.

Case presentation:

We constructed a descriptive case series from a retrospective review of medical records from April to December 2013 at an 800-bed urban hospital. All three patients (ages: 52, 55 and 57 years) were undomiciled/homeless men with a history of alcoholism. Although they had negative blood cultures, echocardiography demonstrated aortic/mitral valve perforation and regurgitation in one patient, aortic/mitral valve vegetation with mitral regurgitation in the second patient, and aortic valve vegetation with regurgitation in the third patient. The patients had positive serum immunoglobulin G (IgG) with negative immunoglobulin M (IgM). PCR on DNA extracted from cardiac valves was positive for , and DNA sequencing of PCR amplicons identified . Patients received treatment with doxycycline/rifampin or doxycycline/gentamicin.

Conclusion:

Clinicians should consider endocarditis as a differential diagnosis in patients who fit elements of the Duke Criteria, as well as having a history of homelessness and alcoholism.

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2016-07-11
2019-12-12
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