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Table 52.10

Causes of Blood Culture-Negative Endocarditis

Prior antibiotic therapy (at least 50%)

Slow-growing organisms (some members of the HACEK* group)

Mould endocarditis (e.g. Aspergillus species)

Infective endocarditis due to Coxiella burnetii or Bartonella species

Thrombotic, non-infected (‘marantic’) endocarditis (e.g. systemic lupus erythematosus or cancer)

* HACEK is an acronym referring to the following organisms: Haemophilus species, Aggregatibacter (previously Actinobacillus) species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species. Organisms of the HACEK group are oro-pharyngeal commensals.