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October 1984

[ill]ulture-Negative' Prosthetic [ill]alve Endocarditis: [ill]azards of Postoperative Steroid Therapy [ill]r Unexplained Fever

Author Affiliations

[ill]rom the Division of Infectious Diseases, Department of Medicine, [ill]tefiore Medical Center, Bronx, New York (Drs Hilton and Lowy); and Section of Infectious Diseases, Department of Medicine, Lenox Hill [ill]pital, New York (Drs Lerner and Tapper).

Arch Intern Med. 1984;144(10):2083-2084. doi:10.1001/archinte.1984.04400010210037

• Two patients had prolonged unexplained fever along with [ill]tiple negative blood cultures after cardiac valve replace[ill]ent surgery. Following the administration of corticosteroids [ill] presumed postpericardiotomy syndrome, both patients [ill]proved symptomatically and defervesced, only to have [ill]sitive blood cultures for Staphylococcus epidermidis [ill]ortly thereafter. The theoretical and practical risks of the [ill]piric use of anti-inflammatory agents for unexplained post[ill]erative fever are reviewed. "Culture-negative" prosthetic [ill]vular infection due to prior antibiotic prophylaxis or therapy [ill]st be strongly considered in the evaluation of such unex[ill]ined fever.

(Arch Intern Med 1984;144:2083-2084)

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