Infectious Disease consult recommended
Epidemiological factors
History of prior infections including cardiovascular infections
Exposure to antimicrobials
Clinical course
Severity
Extra-cardiac sites of infection
Cultures are negative in infective endocarditis for 3 major reasons
Administration of antimicrobial agents prior to obtaining cultures
Inadequate microbiological techniques
Infection with highly fastidious bacteria or non-bacterial pathogens (i.e. fungi)