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diagnosis differential endocarditis infectiousdiseases causes infective bcnie fungal management microbiology algorithm betadglucan bloodculture bloodcultures cnie comparison falsepositives fungus galactomannan incidence
Microorganisms Responsible for Infective Endocarditis Native valves: - Streptococcus viridans - Enterococci - Other streptococci
bacilli - Fungi ... (Candida, Aspergillus ... Histoplasma) - Culture ... bacilli - Fungi ... #Endocarditis #Bacteria
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 ... #CNIE #BCNIE #cardiology
Transplant Infections Timeline Pre-transplant: • Common bacteria (endogenous): Staphylococci (skin), Gram-negative bacilli (gut) • Viruses: HSV (reactivation) Engraftment:
Staphylococci (skin), Gram-negative ... Staphylococci (skin), Gram-negative ... : Candida spp. ... (mucosa), Aspergillus ... : Aspergillus spp
My Patient with Infective Endocarditis (IE) Has Negative Blood Cultures - Did they receive antibiotics prior
Blood Cultures ... have a fastidious bacteria ... this be a non-bacterial ... Fungal (Histoplasma/Aspergillus ... patient a surgical candidate
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 ... ) and 18S ( fungi
Important Fungal Stains Mycology Lab: • Calcofluor white - Fluorochrome that binds glucans and chitin in fungal
preparation from culture ... cell response to fungi ... exceptions are Aspergillus ... • India ink - "Negative ... #microbiology #microscopy
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 ... closely related fungi
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 ... • Persistent bacteremia ... diagnosis #management #cardiology
Endocarditis - Overview and Differential Diagnosis Framework Who? Infectious: • Pre-existing valvular disease • Prosthetic valve • Congenital heart disease • IV
Hypercoagulable (APLAS ... Negative: • Bartonella ... Tropheryma Whipplei • Aspergillus ... • Persistent bacteremia ... Differential #Diagnosis #cardiology
Causes of Myocarditis 1. Infectious Myocarditis • Bacterial - Staphylococcus, Streptococcus, Pneumococcus, Meningococcus, Gonococcus, Salmonella, Corynebacterium
Myocarditis • Bacterial ... ) • Fungal - Aspergillus ... , Blastomyces, Candida ... lymphocytic, infection-negative ... differential #diagnosis #cardiology
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