Culture-negative endocarditis: Difference between revisions

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!Diagnostic tests
  
!Diagnostic tests
 
|-
  
|-
−
|[[Brucella species]]
 +
|[[Brucella]]
 
|unpasteurized dairy
  
|unpasteurized dairy
 
|blood cultures, serology, culture, immunohistology, PCR
  
|blood cultures, serology, culture, immunohistology, PCR
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|serology (IgG phase I >1:800), tissue culture, immunohistology, PCR
  
|serology (IgG phase I >1:800), tissue culture, immunohistology, PCR
 
|-
  
|-
−
|[[Bartonella species]]
 +
|[[Bartonella]]
 
|cat exposure, louse exposure, crowding, homelessness
  
|cat exposure, louse exposure, crowding, homelessness
 
|blood cultures, serology, culture, immunohistology, PCR
  
|blood cultures, serology, culture, immunohistology, PCR
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|histology and PCR
  
|histology and PCR
 
|-
  
|-
−
|[[Mycoplasma species]]
 +
|[[Mycoplasma]]
 
|
  
|
 
|serology, culture, immunohistology, PCR
  
|serology, culture, immunohistology, PCR
 
|-
  
|-
−
|[[Legionella species]]
 +
|[[Legionella]]
 
|
  
|
 
|blood cultures, serology, culture, immunohistology, PCR
  
|blood cultures, serology, culture, immunohistology, PCR
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* Occupational exposures
  
* Occupational exposures
 
** Butchers, fishermen, homemakers, veterinarians, farmers: [[Erysipelothrix rhusiopathiae]]
  
** Butchers, fishermen, homemakers, veterinarians, farmers: [[Erysipelothrix rhusiopathiae]]
−
** Farmers, veterinarians: [[Coxiella burnetii]], [[Brucella species]]
 +
** Farmers, veterinarians: [[Coxiella burnetii]], [[Brucella]]
 
* Intravenous drug use:
  
* Intravenous drug use:
−
** Right-sided with advanced [[HIV]]: [[Salmonella species]], [[Neisseria subflava]]
 +
** Right-sided with advanced [[HIV]]: [[Salmonella]], [[Neisseria subflava]]
 
** [[Pharyngitis]]: [[Corynebacterium diphtheriae]]
  
** [[Pharyngitis]]: [[Corynebacterium diphtheriae]]
−
** Other: [[Neisseria sicca]], [[Clostridium species]], [[Candida species]]
 +
** Other: [[Neisseria sicca]], [[Clostridium]], [[Candida]]
−
* Open heart surgery: [[Legionella species]], [[non-tuberculous mycobacteria]] including [[Mycobacterium avium complex]], [[Nocardia species]]
 +
* Open heart surgery: [[Legionella]], [[non-tuberculous mycobacteria]] including [[Mycobacterium avium complex]], [[Nocardia]]
−
* Gastroenteritis: [[Salmonella species]]
 +
* Gastroenteritis: [[Salmonella]]
 
* Sinusitis: [[Haemophilus influenzae]]
  
* Sinusitis: [[Haemophilus influenzae]]
 
* [[Pneumonitis]]: [[Chlamydia psittaci]]
  
* [[Pneumonitis]]: [[Chlamydia psittaci]]
 
* [[Diarrhea]]: [[Tropheryma whipplei]]
  
* [[Diarrhea]]: [[Tropheryma whipplei]]
−
* [[Urinary tract infection]]: [[Klebsiella species]]
 +
* [[Urinary tract infection]]: [[Klebsiella]]
 
* Dental procedures: [[Kingella kingae]], [[Cardiobacterium hominis]], [[Actinobacillus actinomicetemcomitans]], [[Haemophilus parainfluenzae]], [[Lactobacillus speies]]
  
* Dental procedures: [[Kingella kingae]], [[Cardiobacterium hominis]], [[Actinobacillus actinomicetemcomitans]], [[Haemophilus parainfluenzae]], [[Lactobacillus speies]]
 
** Cirrhosis and alcoholism: [[Campylobacter fetus]]
  
** Cirrhosis and alcoholism: [[Campylobacter fetus]]
−
** Immunocompromised patient: [[Gemella species]]
 +
** Immunocompromised patient: [[Gemella]]
 
** Intravenous drug use: [[Eikonella corrodens]]
  
** Intravenous drug use: [[Eikonella corrodens]]
−
** Urinary tract infection: [[Haemophilus species]]
 +
** Urinary tract infection: [[Haemophilus]]
 
* [[Sexually-transmitted infection]]: [[Neisseria gonorrhoeae]]
  
* [[Sexually-transmitted infection]]: [[Neisseria gonorrhoeae]]
 
* Medicinal leeches: [[Aeromonas hydrophila]]
  
* Medicinal leeches: [[Aeromonas hydrophila]]
−
* Dog or cat exposure: [[Pasteurella species]], [[Bartonella henselae]] (cats)
 +
* Dog or cat exposure: [[Pasteurella]], [[Bartonella henselae]] (cats)
−
* Cattle exposure with prosthetic valve: [[Coxiella burnetii]], [[Brucella species]]
 +
* Cattle exposure with prosthetic valve: [[Coxiella burnetii]], [[Brucella]]
 
* Pregnancy: [[Listeria monocytogenes]]
  
* Pregnancy: [[Listeria monocytogenes]]
−
* [[Cirrhosis]] or chronic alcohol use: [[Bartonella quintana]], [[Erysipelothrix species]], [[Campylobacter species]], [[Aeromonas species]], [[Pasteurella species]], [[Listeria monocytogenes]]
 +
* [[Cirrhosis]] or chronic alcohol use: [[Bartonella quintana]], [[Erysipelothrix]], [[Campylobacter]], [[Aeromonas]], [[Pasteurella]], [[Listeria monocytogenes]]
   
 
== Investigations ==
  
== Investigations ==

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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