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diagnosis infectiousdiseases differential fungal cardiology infective negative algorithm bcnie comparison microbiology bacteria bloodculture bloodcultures bloodstream candidemia candidiasis catheter causes clinical
My Patient with Infective Endocarditis (IE) Has Negative Blood Cultures - Did they receive antibiotics prior
with Infective Endocarditis ... Fungal (Histoplasma/Aspergillus ... patient a surgical candidate ... #Infective #Endocarditis ... BloodCultures #Diagnosis #Management
Microorganisms Responsible for Infective Endocarditis Native valves: - Streptococcus viridans - Enterococci - Other streptococci
for Infective Endocarditis ... bacilli - Fungi (Candida ... , Aspergillus, Histoplasma ... ) - Culture negative ... streptococci - Culture
Causes of blood culture negative infective endocarditis Bartonella spp, Brucella spp, Coxiella burnetii, Chlamydia spp, Tropheryma whipplei,
Causes of blood culture ... negative infective endocarditis ... whipplei, Fungi (Aspergillus ... , Candida), Mycoplasma ... #negative #Endocarditis
Common Fungal Pathology • Candida - Small yeast intermingled with pseudohyphae • Aspergillosis - Septate
Pathology • Candida ... Pathology #clinical #microscopy ... #table #atlas #
Endocarditis Summary Who? Infectious: • Pre-existing valvular disease • Prosthetic valve • Congenital heart disease • IV substance use • IV catheter • Recent
Hypercoagulable (APLAS ... 90% of IE cases Culture ... Tropheryma Whipplei • Aspergillus ... • Blood cultures ... #diagnosis #management
Blood Culture-Negative Infective Endocarditis (BCNIE) Definition: No etiology found after 3 separate blood cultures remain negative for
Blood Culture-Negative ... Infective Endocarditis ... whipplei, Fungi (Aspergillus ... , Candida), Mycoplasma ... Negative #Infective #Endocarditis
Candidemia Workup and Management - IDSA Guidelines 1) Antibiotics • Empiric: Echinocandins (e.g. micafungin) for most patients
Candidemia Workup and Management ... Susceptibilities, Negative Cultures ... clinical concern for endocarditis ... IDSA #Guidelines #Management ... #candida #candidiasis
Endocarditis - Overview and Differential Diagnosis Framework Who? Infectious: • Pre-existing valvular disease • Prosthetic valve • Congenital heart disease • IV
Endocarditis - Overview ... Hypercoagulable (APLAS ... 90% of IE cases Culture ... Tropheryma Whipplei • Aspergillus ... #Endocarditis
Important Fungal Stains Mycology Lab: • Calcofluor white - Fluorochrome that binds glucans and chitin in fungal
preparation from culture ... exceptions are Aspergillus ... #microbiology #microscopy ... fungus #comparison #table
Suspected catheter-related bloodstream infection - Management Algorithm • Temperature 37.8 C • Rigors
Obtain blood cultures ... Hemodynamically stable ... Antibiotic Management ... metastatic infection (endocarditis ... Hernodynamically stable
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