G. Popescu *, Cristina Popescu **
* Dr. Gabriel Popescu – asistent universitar
** Dr. Cristina Popescu – preparator, Clinica I Boli Infecţioase Colentina, UMF „Carol Davila”
Abstract
Sterile blood cultures in infective endocarditis have been noted in 3 – 54%. This may be due to several factors: self-medication before admission, defaults of microbiology laboratories, subacute right-sided endocarditis, slow growth of fastidious organisms (such as anaerobes, fungies, HACEK, nutritionally variant streptococci…). Serologic tests and newer dianostic techniques may reduce the proportion of “culture-negative” cases. The therapy is controversial, but the regimen usually used will cover the enterococcus and fastidious Gram negative bacili and consists of a combination of aminopenicillin and aminoglycoside. When staphylococcal endocarditis is a strong consideration a cephalosporin (of I/II generation) in full dosage should be added. Vacomycin is recommended for the therapy of infective endocardites in patients with penicillin aliergy or when the microorganisms are methicillin resistant. Surgical therapy have some indications like in other infective endocarditis, but empirical regimens used increased failures and subsequently surgical indications.