The clinical utility of tissue polymerase chain reaction, tissue culture and tissue histology in blood culture-negative infective endocarditis in South Africa - insights from the Groote Schuur Hospital Infective Endocarditis Registry.

In this single-centre study, perioperative serum serological testing was underutilised in blood culture-negative infective endocarditis.

Tissue polymerase chain reaction was valuable in determining the aetiology of blood culture-negative infective endocarditis, and influenced management.

Tissue culture and histopathology had a poor yield and added little value in identifying the microbiological cause of blood culture-negative infective endocarditis.

Finally, the most common blood culture-negative infective endocarditis causative organism identified by additional non-culture testing in our setting is Bartonella spp.