Culture-negative endocarditis: Difference between revisions
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| + | == Differential Diagnosis == |
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| + | === Common Fastidious Organisms === |
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|[[Bartonella species]] |
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+ | |cat exposure, louse exposure, crowding, homelessness |
|blood cultures, serology, culture, immunohistology, PCR |
|blood cultures, serology, culture, immunohistology, PCR |
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|blood cultures, serology, PCR |
|blood cultures, serology, PCR |
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| + | === Organisms by Risk Factor === |
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| + | |||
| + | * Homelessness with body lice: [[Bartonella quintana]] |
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| + | * Occupational exposures |
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| + | ** Butchers, fishermen, homemakers, veterinarians, farmers: [[Erysipelothrix rhusiopathiae]] |
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| + | ** Farmers, veterinarians: [[Coxiella burnetii]], [[Brucella species]] |
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| + | * Intravenous drug use: |
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| + | ** Right-sided with advanced [[HIV]]: [[Salmonella species]], [[Neisseria subflava]] |
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| + | ** [[Pharyngitis]]: [[Corynebacterium diphtheriae]] |
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| + | ** Other: [[Neisseria sicca]], [[Clostridium species]], [[Candida species]] |
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| + | * Open heart surgery: [[Legionella species]], [[non-tuberculous mycobacteria]] including [[Mycobacterium avium complex]], [[Nocardia species]] |
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| + | * Gastroenteritis: [[Salmonella species]] |
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| + | * Sinusitis: [[Haemophilus influenzae]] |
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| + | * [[Pneumonitis]]: [[Chlamydia psittaci]] |
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| + | * [[Diarrhea]]: [[Tropheryma whipplei]] |
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| + | * [[Urinary tract infection]]: [[Klebsiella species]] |
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| + | * Dental procedures: [[Kingella kingae]], [[Cardiobacterium hominis]], [[Actinobacillus actinomicetemcomitans]], [[Haemophilus parainfluenzae]], [[Lactobacillus speies]] |
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| + | ** Cirrhosis and alcoholism: [[Campylobacter fetus]] |
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| + | ** Immunocompromised patient: [[Gemella species]] |
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| + | ** Intravenous drug use: [[Eikonella corrodens]] |
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| + | ** Urinary tract infection: [[Haemophilus species]] |
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| + | * [[Sexually-transmitted infection]]: [[Neisseria gonorrhoeae]] |
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| + | * Medicinal leeches: [[Aeromonas hydrophila]] |
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| + | * Dog or cat exposure: [[Pasteurella species]], [[Bartonella henselae]] (cats) |
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| + | * Cattle exposure with prosthetic valve: [[Coxiella burnetii]], [[Brucella species]] |
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| + | * Pregnancy: [[Listeria monocytogenes]] |
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| + | * [[Cirrhosis]] or chronic alcohol use: [[Bartonella quintana]], [[Erysipelothrix species]], [[Campylobacter species]], [[Aeromonas species]], [[Pasteurella species]], [[Listeria monocytogenes]] |
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| + | |||
| + | == Investigations == |
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| + | |||
| + | * Blood cultures |
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| + | ** Routine, modern blood culture incubation will grow almost all easily-cultivable bacteria |
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| + | |||
[[Category:Cardiac infections]] |
[[Category:Cardiac infections]] |
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[[Category:Infectious diseases]] |
[[Category:Infectious diseases]] |
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Revision as of 11:48, 22 October 2020
Differential Diagnosis
Common Fastidious Organisms
| Organism | Clinical clues | Diagnostic tests |
|---|---|---|
| Brucella species | 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 species | cat exposure, louse exposure, crowding, homelessness | blood cultures, serology, culture, immunohistology, PCR |
| Tropheryma whipplei | histology and PCR | |
| Mycoplasma species | serology, culture, immunohistology, PCR | |
| Legionella species | 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 species
- Intravenous drug use:
- Right-sided with advanced HIV: Salmonella species, Neisseria subflava
- Pharyngitis: Corynebacterium diphtheriae
- Other: Neisseria sicca, Clostridium species, Candida species
- Open heart surgery: Legionella species, non-tuberculous mycobacteria including Mycobacterium avium complex, Nocardia species
- Gastroenteritis: Salmonella species
- Sinusitis: Haemophilus influenzae
- Pneumonitis: Chlamydia psittaci
- Diarrhea: Tropheryma whipplei
- Urinary tract infection: Klebsiella species
- Dental procedures: Kingella kingae, Cardiobacterium hominis, Actinobacillus actinomicetemcomitans, Haemophilus parainfluenzae, Lactobacillus speies
- Cirrhosis and alcoholism: Campylobacter fetus
- Immunocompromised patient: Gemella species
- Intravenous drug use: Eikonella corrodens
- Urinary tract infection: Haemophilus species
- Sexually-transmitted infection: Neisseria gonorrhoeae
- Medicinal leeches: Aeromonas hydrophila
- Dog or cat exposure: Pasteurella species, Bartonella henselae (cats)
- Cattle exposure with prosthetic valve: Coxiella burnetii, Brucella species
- Pregnancy: Listeria monocytogenes
- Cirrhosis or chronic alcohol use: Bartonella quintana, Erysipelothrix species, Campylobacter species, Aeromonas species, Pasteurella species, Listeria monocytogenes
Investigations
- Blood cultures
- Routine, modern blood culture incubation will grow almost all easily-cultivable bacteria
