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diagnosis endocarditis infectiousdiseases cardiology fungal bcnie betadglucan causes galactomannan infective microbiology biomarkers bloodculture cnie falsepositives fungus incidence infections laboratory management
Microorganisms Responsible for Infective Endocarditis Native valves: - Streptococcus viridans - Enterococci - Other streptococci
bacilli - Fungi ... (Candida, Aspergillus ... bacilli - Fungi ... #Endocarditis #Bacteria ... Pathogens #Diagnosis #Differential
Transplant Infections Timeline Pre-transplant: • Common bacteria (endogenous): Staphylococci (skin), Gram-negative bacilli (gut) • Viruses: HSV (reactivation) Engraftment:
Staphylococci (skin), Gram-negative ... : Candida spp. ... (mucosa), Aspergillus ... : Aspergillus spp ... Infections #Timeline #differential
Causes of blood culture negative infective endocarditis Bartonella spp, Brucella spp, Coxiella burnetii, Chlamydia spp, Tropheryma whipplei,
negative infective ... Tropheryma whipplei, Fungi ... (Aspergillus, Candida ... under BCNIE, these bacteria ... BCNIE #Causes #differential
Blood Culture-Negative Infective Endocarditis (BCNIE) Definition: No etiology found after 3 separate blood cultures remain negative for
Blood Culture-Negative ... remain negative ... or fungi (grows ... (Aspergillus, Candida ... Endocarditis #diagnosis #differential
Important Fungal Stains Mycology Lab: • Calcofluor white - Fluorochrome that binds glucans and chitin in fungal
preparation from culture ... exceptions are Aspergillus ... • India ink - "Negative ... #fungus #comparison ... #table
Fungal Biomarkers: Beta-D-Glucan and Aspergillus Galactomannan Beta-D-Glucan: • Polysaccharide cell wall component of many fungi • Pathogens:
component of many fungi ... • Pathogens: Candida ... Coccidioides - Negative ... BAL GM does not differentiate ... Galactomannan #diagnosis #comparison
1,3-Beta-D-Glucan and Galactomannan Testing Sensitivity Specificity and False Positives 1,3-Beta-D-Glucan • Cell wall component of many fungi
component of many fungi ... • Routine use: Candida ... Almost always negative ... Infections with certain bacteria ... in BAL does not differentiate
Endocarditis Summary Who? Infectious: • Pre-existing valvular disease • Prosthetic valve • Congenital heart disease • IV substance use • IV catheter • Recent
Hypercoagulable (APLAS ... • Coagulase-negative ... Tropheryma Whipplei • Aspergillus ... Marantic (NTBE) Differential ... • Persistent bacteremia
Endocarditis - Overview and Differential Diagnosis Framework Who? Infectious: • Pre-existing valvular disease • Prosthetic valve • Congenital heart disease • IV
- Overview and Differential ... Hypercoagulable (APLAS ... Negative: • Bartonella ... Tropheryma Whipplei • Aspergillus ... • Persistent bacteremia
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