Blood culture-negative endocarditis is often severe and difficult to diagnose. It is necessary to emphasize the importance for the\nearly diagnosis and accurate treatment of blood culture-negative endocarditis. Here, we described the relevant clinical information\nof a blood culture-negative but clinically diagnosed infective endocarditis complicated by intracranial mycotic aneurysm, brain\nabscess, and posterior tibial artery pseudoaneurysm. This patient was a 65-year-old man with a 9-month history of intermittent\nfever and died in the end for the progressive neurological deterioration. Although the blood culture is negative, this patient was\nclinically diagnosed as infective endocarditis according to Duke criteria. This patient course was complicated not only by cerebral\nembolism, intracranialmycotic aneurysm, and brain abscess but also by posterior tibial artery aneurysmof the lower extremity.The\nclinical findings of this patient suggest that the confirmatory microbiology is essential for the treatment of blood culture-negative\ninfective endocarditis. Clinicians should be aware of the detriment of blood culture-negative infective endocarditis for its multiple\ncomplications may occur in one patient. The delayed etiological diagnosis and insufficient treatment may aggregate the clinical\noutcome of blood culture-negative infective endocarditi
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