Culture-negative endocarditis: Difference between revisions
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** Cirrhosis and alcoholism: [[Campylobacter fetus]] |
** Cirrhosis and alcoholism: [[Campylobacter fetus]] |
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** Immunocompromised patient: [[Gemella]] |
** Immunocompromised patient: [[Gemella]] |
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** Intravenous drug use: [[ |
** Intravenous drug use: [[Eikenella corrodens]] |
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** Urinary tract infection: [[Haemophilus]] |
** Urinary tract infection: [[Haemophilus]] |
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* [[Sexually-transmitted infection]]: [[Neisseria gonorrhoeae]] |
* [[Sexually-transmitted infection]]: [[Neisseria gonorrhoeae]] |
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Latest revision as of 16:29, 30 July 2025
Differential Diagnosis
Common Fastidious Organisms
| Organism | Clinical clues | Diagnostic tests |
|---|---|---|
| Brucella | unpasteurized dairy | blood cultures, serology, culture, immunohistology, PCR |
| Coxiella burnetii | animal exposure (especially pregnant sheep) | serology (IgG phase I >1:800), tissue culture, immunohistology, PCR |
| Bartonella | cat exposure, louse exposure, crowding, homelessness | blood cultures, serology, culture, immunohistology, PCR |
| Tropheryma whipplei | histology and PCR | |
| Mycoplasma | serology, culture, immunohistology, PCR | |
| Legionella | blood cultures, serology, culture, immunohistology, PCR | |
| Fungi | IV drug use, immunocompromise | blood cultures, serology, PCR |
Organisms by Risk Factor
- Homelessness with body lice: Bartonella quintana
- Occupational exposures
- Butchers, fishermen, homemakers, veterinarians, farmers: Erysipelothrix rhusiopathiae
- Farmers, veterinarians: Coxiella burnetii, Brucella
- Intravenous drug use:
- Right-sided with advanced HIV: Salmonella, Neisseria subflava
- Pharyngitis: Corynebacterium diphtheriae
- Other: Neisseria sicca, Clostridium, Candida
- Open heart surgery: Legionella, non-tuberculous mycobacteria including Mycobacterium avium complex, Nocardia
- Gastroenteritis: Salmonella
- Sinusitis: Haemophilus influenzae
- Pneumonitis: Chlamydia psittaci
- Diarrhea: Tropheryma whipplei
- Urinary tract infection: Klebsiella
- Dental procedures: Kingella kingae, Cardiobacterium hominis, Actinobacillus actinomicetemcomitans, Haemophilus parainfluenzae, Lactobacillus speies
- Cirrhosis and alcoholism: Campylobacter fetus
- Immunocompromised patient: Gemella
- Intravenous drug use: Eikenella corrodens
- Urinary tract infection: Haemophilus
- Sexually-transmitted infection: Neisseria gonorrhoeae
- Medicinal leeches: Aeromonas hydrophila
- Dog or cat exposure: Pasteurella, Bartonella henselae (cats)
- Cattle exposure with prosthetic valve: Coxiella burnetii, Brucella
- Pregnancy: Listeria monocytogenes
- Cirrhosis or chronic alcohol use: Bartonella quintana, Erysipelothrix, Campylobacter, Aeromonas, Pasteurella, Listeria monocytogenes
Investigations
- Blood cultures
- Routine, modern blood culture incubation will grow almost all easily-cultivable bacteria
