Table 3

Causes of misclassification of patients with BCNIE as possible rather than definite endocarditis by the modified Duke/ESC 2015 clinical criteria

CaseMajor imaging criteriaNo of minor criteria presentPossible cause of misclassification
1Vegetation2Antibiotic use prior to blood culture sampling
2Vegetation2Bartonella quintana*
3Dehiscence of a prosthetic valve. FDG PET-CT positive2Systemic lupus erythematosus with possible Mycobacterium tuberculosis†
4Vegetation with tissue destruction
FDG PET-CT positive
0Mycobacterium tuberculosis†
5Vegetation/Abscess2Bartonella quintana*
8Vegetation/perforation2Bartonella quintana*
9Vegetation/perforation1Mycoplasma species‡
10Vegetation2Bartonella quintana*
11Vegetation/perforation2Alternaria species
2Bartonella quintana*
13Abscess2Mycobacterium tuberculosis†
14Vegetation/perforation2Bartonella quintana*
15Vegetation/perforation2Bartonella quintana*
16Vegetation/perforation2Bartonella quintana*
17Vegetation2Antibiotic use prior to blood culture sampling
Vegetation, perforation0Unknown
19Vegetation, perforation2Antibiotic use prior to blood culture sampling, Streptococcus gallolyticus subsp. pasteurianus identified by PCR of valve tissue
  • *Diagnosis based on positive serology and PCR performed on valve tissue.

  • †Diagnosis based on typical imaging and histopathological features.1 31

  • ‡Diagnosis based on positive serology.

  • BCNIE, blood culture negative endocarditis; FDG PET/CT, fluorodeoxyglucose positron emission tomography.