Evidence map›Paper›PMID 30139783›Full record

ArticleBMJ case reports2018

Blood culture-negative endocarditis presenting as altered mental status.

Joshua R Dilley, Charles R Clinch

Open access · greenAbstract readCase Reports
In one paragraph

Article in BMJ case reports, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Joshua R DilleyFamily and Community Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.
Charles R ClinchWake Forest School of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.ORCID http://orcid.org/0000-0003-1123-5342
Atrium Health Wake Forest Baptist · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Blood culture-negative endocarditis (BCNE) is difficult to diagnose because one of the major criteria to raise suspicion for endocarditis, a positive blood culture, is absent. BCNE accounts for 2.5% to 31% of all cases of endocarditis. Our report describes a 69-year-old woman with end-stage renal disease who presented with altered mental status. Physical examination and testing, including complete blood count, comprehensive metabolic panel, chest X-ray and head CT were otherwise unremarkable. Brain MRI revealed multiple areas of decreased diffusion concerning for cardioembolic stroke. A transthoracic echocardiogram demonstrated an abnormality on the mitral valve. Operative evaluation revealed a purulent mitral valve with vegetative clumps. Cultures of the vegetation and the blood grew no organisms. BCNE is a rare entity; neurological abnormalities may be the only presenting signs/symptoms. Endocarditis should be considered among the causes of altered mental status, even in the absence of positive blood cultures.

Indexed as

AgedAnti-Bacterial AgentsAnticoagulantsBlood CultureConsciousness DisordersDiagnosis, DifferentialEchocardiographyEndocarditisFemaleHeparinHumansMagnetic Resonance ImagingMitral ValveAnti-Bacterial AgentsAnticoagulantsHeparininfectious diseasesvalvar diseases

Identifiers

PMID30139783
PMCPMC6109729
OpenAlexW2888651863

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.