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Afebrile Blood Culture–Negative Endocarditis

Didier Raoult, MD, PhD
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Université de la Méditerranée; 13385 Marseille, France (Raoult)

Requests for Reprints: Didier Raoult, MD, PhD, Unité des Rickettsies, Cnrs Upresa 6020, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille cedex 05, France.

Ann Intern Med. 1999;131(2):144-146. doi:10.7326/0003-4819-131-2-199907200-00012
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Fever, positive blood culture, and the presence of valvular vegetation on echocardiography are the usual indicators of infective endocarditis. If a patient does not have a fever, however, clinicians frequently do not consider this diagnosis. In such cases, diagnosis may be delayed until hemodynamic compromise necessitates valve replacement, as in the case of Coxiella burnetii infective endocarditis (1) and the report by Gubler and colleagues (2) in this issue.

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