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diagnosis infectiousdiseases differential infective negative algorithm bcnie cardiology comparison microbiology bacteria bloodculture bloodcultures bloodstream candidemia candidiasis catheter causes clinical cnie
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 ... BloodCultures #Diagnosis #Management
Microorganisms Responsible for Infective Endocarditis Native valves: - Streptococcus viridans - Enterococci - Other streptococci
for Infective Endocarditis ... Gram-negative bacilli - Fungi ... (Candida, Aspergillus ... Histoplasma) - Culture ... 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 ... Tropheryma whipplei, Fungi ... (Aspergillus, Candida ... #negative #Endocarditis
Important Fungal Stains Mycology Lab: • Calcofluor white - Fluorochrome that binds glucans and chitin in fungal
Important Fungal ... preparation from culture ... exceptions are Aspergillus ... #microbiology #microscopy ... #table
Common Fungal Pathology • Candida - Small yeast intermingled with pseudohyphae • Aspergillosis - Septate
Common Fungal Pathology ... • Candida - Small ... Medicine @ucsdim #Fungal ... Pathology #clinical #microscopy ... #table #atlas #
Blood Culture-Negative Infective Endocarditis (BCNIE) Definition: No etiology found after 3 separate blood cultures remain negative for
Infective Endocarditis ... fastidious bacteria or fungi ... Tropheryma whipplei, Fungi ... (Aspergillus, Candida ... Negative #Infective #Endocarditis
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
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 ... #candida #candidiasis ... #treatment #fungal
Suspected catheter-related bloodstream infection - Management Algorithm • Temperature 37.8 C • Rigors
Obtain blood cultures ... Hemodynamically stable ... metastatic infection (endocarditis ... pathogens (S. aureus, fungal ... Hernodynamically stable
Mycoses HISTOPLASMOSIS • Inhalation of conidia → Yeast → travel to lymph nodes → spread in body • Bird
• Confirmed by culture ... ASPERGILLOSIS • Aspergillus ... Diagnosis: • Culture ... arthritis, and endocarditis ... #Diagnosis #Management
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