Challenges in the Diagnosis and Management of Culture-Negative Infective Endocarditis in a 64-Year-Old Hemodialysis Patient

We report a case of culture-negative infective endocarditis in a 64-year-old hemodialysis patient who presented with fever and dyspnea. Despite empirical antibiotic therapy and negative blood cultures, transesophageal echocardiography later revealed aortic valve vegetation and destruction. The patient developed cardiogenic shock and died before surgery. This case illustrates the diagnostic challenges of culture-negative infective endocarditis, especially in high-risk populations. Early blood culture collection and continuous reassessment of surgical timing are crucial to improve outcomes.