Culture-negative endocarditis: Difference between revisions

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== Differential Diagnosis ==
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=== Common Fastidious Organisms ===
 
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|serology (IgG phase I >1:800), tissue culture, immunohistology, PCR
 
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|[[Bartonella species]]
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|[[Bartonella]]
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|cat exposure, louse exposure, crowding, homelessness
 
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|histology and PCR
 
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|[[Mycoplasma]]
 
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|serology, culture, immunohistology, PCR
  
|serology, culture, immunohistology, PCR
 
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|[[Legionella]]
 
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|blood cultures, serology, culture, immunohistology, 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]]
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* Intravenous drug use:
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** Right-sided with advanced [[HIV]]: [[Salmonella]], [[Neisseria subflava]]
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** [[Pharyngitis]]: [[Corynebacterium diphtheriae]]
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** Other: [[Neisseria sicca]], [[Clostridium]], [[Candida]]
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* Open heart surgery: [[Legionella]], [[non-tuberculous mycobacteria]] including [[Mycobacterium avium complex]], [[Nocardia]]
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* Gastroenteritis: [[Salmonella]]
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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]]
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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]]
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** Intravenous drug use: [[Eikonella corrodens]]
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** Urinary tract infection: [[Haemophilus]]
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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]], [[Bartonella henselae]] (cats)
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* Cattle exposure with prosthetic valve: [[Coxiella burnetii]], [[Brucella]]
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* Pregnancy: [[Listeria monocytogenes]]
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* [[Cirrhosis]] or chronic alcohol use: [[Bartonella quintana]], [[Erysipelothrix]], [[Campylobacter]], [[Aeromonas]], [[Pasteurella]], [[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]]
 
[[Category:Infectious diseases]]
  
[[Category:Infectious diseases]]

Latest revision as of 13:01, 25 January 2022

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

Investigations

  • Blood cultures
    • Routine, modern blood culture incubation will grow almost all easily-cultivable bacteria
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