Urban trench fever presenting as culture-negative endocarditis

Abstract

A young Russian man presented with increasing shortness of breath and signs of worsening aortic regurgitation. A diagnosis of infective endocarditis was made before emergency valve replacement. The infective cause was not discovered by routine culture but was suggested by electron microscopy and confirmed by serology and PCR testing. © The Author 2008. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved.