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Culture negative endocarditis represents 5-10% of infectious endocarditis
Most common cause is probably the administration of antibiotics prior to adequate blood culture collection, especially when streptococcal
Fastidious organisms: Coxiella, Bartonella, Brucella, T. whipplei, Legionella, and others
Serologic testing can be considered in the context of the history (travel, activities, animal contact)
Infectious diseases consult recommended