European Journal of Biomedical and Pharmaceutical Sciences

A CASE REPORT OF CULTURE NEGATIVE INFECTIVE ENDOCARDITIS IN A HIGH RISK YOUNG ADULT

*Dr. B. Sai Krishna Yadav, Dr. M. Rama Devi, Dr. P. V. Harish, Dr. C. Ramesh Kumar and
Dr. K. Praveen

ABSTRACT

Background: Infective endocarditis (IE) is a serious cardiac infection associated with high morbidity and
mortality. The diagnosis becomes particularly challenging when blood cultures are negative, commonly due to
prior antibiotic use. Early recognition is essential, especially in patients with known risk factors such as intravenous
(IV) drug use, alcohol abuse, and high-risk sexual behavior. Case Summary: We present the case of a 23-year-old
male OT technician with a 15-day history of high-grade continuous fever, burning micturition, and 2-day history of
slurring of speech. He has a history of IV drug abuse, chronic alcoholism, and illicit sexual exposure. He is initially
treated at a private hospital before presenting to our hospital with neurological symptoms. 2D echocardiography
revealed vegetation on the posterior mitral leaflet with severe mitral regurgitation. Blood cultures are sterile. A
diagnosis of culture-negative infective endocarditis is made based on modified Duke criteria. The patient is treated with
intravenous vancomycin for 4 weeks. Conclusion: This case underscores the importance of clinical suspicion in
diagnosing culture-negative infective endocarditis, especially in patients with risk factors and prior antibiotic use.
Echocardiography plays a vital role in diagnosis and monitoring of Infective endocarditis. Empirical antibiotic therapy
can be effective in managing these challenging cases.

Keywords: Culture-negative infective endocarditis, intravenous drug use ,vegetation on posterior mitral leaflet, Modified Duke criteria.