Predictors of Persistent Fever Among Patients With Suspected Infective Endocarditis: Think Outside the box

Abstract

Background: Fever is common in infective endocarditis (IE), yet little is known about fever duration in such patients. We aim to identify predictors of persistent fever in patients with suspected IE. Methods: This study was conducted at the Lausanne University Hospital, Switzerland, from January 2014 to June 2023. All patients with suspected IE being febrile upon presentation were included. Fever (>38°C) was considered persistent if it continued for at least 96 hours from antimicrobial treatment initiation. A case was classified as IE by the Endocarditis Team. Results: Among 1399 episodes with suspected IE, persistent fever was observed in 260 (19%) episodes. IE was diagnosed in 536 (41%) episodes, of which 82 (15%) had persistent fever. Among episodes with suspected IE, persistent bacteremia/candidemia for 96 hours (P