Investigations

Mild to moderate anemia is commonly present in IE with a normochromic, normocytic picture. Neutrophil leukocytosis is common and the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are elevated in 90% of patients and the latter have been proposed as additional minor criteria to the Duke classification of IE [1–4]. Intraleukocyte bacteria can be seen in buffy coat preparations of blood in up to 50% of cases [5].