Management of complicated infective endocarditis

We read with great interest the case report of Lamichhane et al.[1] recently published in the Annals of Medicine & Surgery. They reported a case of blood culture-negative infective endocarditis complicated by multiple organ abscesses (in the brain, spleen, and liver) and lumbar vertebral discitis. We have some criticisms regarding the management of this interesting case. Considering the duration of symptoms and the most common aetiological agent of multiple organ abscesses and vertebral discitis, their patient probably suffered from acute infective endocarditis caused by Staphylococcus aureus[2,3]. No growth was detected in blood cultures. However, we believe that abscess culture either from the brain, spleen, or liver could be helpful to demonstrate the causative pathogen.