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Blood culture negative endocarditis

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https://www.readbyqxmd.com/read/28062425/first-reported-case-of-disseminated-nocardia-kroppenstedtii-sp-nov-infection-presenting-with-brain-abscess-and-endocarditis-in-an-immunocompromised-patient-with-mantle-cell-lymphoma-challenges-in-diagnosis-and-treatment
#1
Aneela Majeed, Hafez Mohammad Ammar Abdullah, Waqas Ullah, Mayar Al Mohajer
A 72-year-old man with a history of blastoid variant stage IV relapsed refractory mantle cell lymphoma presented with new central nervous system (CNS) symptoms. Brain imaging was positive for rim-enhancing lesions along with a mitral valve mass on the echocardiogram. It was a challenge to establish the exact aetiology of these lesions in this patient. He was empirically treated with chemotherapy on the presumption that the brain lesions were secondary to progressive malignancy. However, brain biopsy was negative for malignancy and blood cultures were found positive for Nocardia kroppenstedtii sp nov...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28051025/retrospective-examination-of-q-fever-endocarditis-an-underdiagnosed-disease-in-the-mainland-of-china
#2
Xiao Han, Jeffrey Hsu, Qi Miao, Bao-Tong Zhou, Hong-Wei Fan, Xiao-Lu Xiong, Bo-Hai Wen, Lian Wu, Xiao-Wei Yan, Quan Fang, Wei Chen
BACKGROUND: Q fever endocarditis, a chronic illness caused by Coxiella burnetii, can be fatal if misdiagnosed or left untreated. Despite a relatively high positive rate of Q fever serology in healthy individuals in the mainland of China, very few cases of Q fever endocarditis have been reported. This study summarized cases of Q fever endocarditis among blood culture negative endocarditis (BCNE) patients and discussed factors attributing to the low diagnostic rate. METHODS: We identified confirmed cases of Q fever endocarditis among 637 consecutive patients with infective endocarditis (IE) in the Peking Union Medical College Hospital between 2006 and 2016...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28035639/mycobacterium-infection-from-a-cardiopulmonary-bypass-heater-cooler-unit-in-a-patient-with-steroid-induced-immunosuppression
#3
Yi Cai, Kevin Landolfo, Johnathan R Renew
PURPOSE: To present a case of mycobacterium infection transmitted through a heater-cooler unit during cardiac bypass surgery. CLINICAL FEATURES: A 63-yr-old woman with a past medical history of aortic coarctation repair in 1963 and a mechanical aortic valve replacement in 2010 was prescribed antibiotics and steroids at an outpatient care facility in September 2015 for symptoms of an upper respiratory tract infection. Four months later, she developed malaise and intermittent fever with anemia and acute kidney dysfunction...
December 29, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28012099/thrombocytopaenia-during-methicillin-sensitive-staphylococcus-aureus-bacteraemia
#4
E Forsblom, I Tielinen, E Ruotsalainen, A Järvinen
The prognostic impact of thrombocytopaenia in Staphylococcus aureus bacteraemia (SAB) has previously been determined at bacteraemia onset only and relevant pre-bacteraemic thrombocytopaenia predisposing parameters have not been accounted for. We evaluated the prognostic impact of low thrombocyte count in SAB excluding pre-bacteraemic factors potentially causing thrombocytopaenia. This was a multicentre retrospective analysis of methicillin-sensitive SAB (MS-SAB) patients. Thrombocyte count was determined at blood culture collection and at days 3 and 7...
December 23, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28005033/-infective-endocarditis-importance-of-molecular-biological-techniques-in-etiological-diagnosis
#5
E O Kotova, E A Domonova, Yu L Karaulova, A S Mil'to, A S Pisaryuk, O Yu Sil'veistrova, O Yu Shipulina, G A Shipulin, V S Moiseev
AIM: To investigate the specific features of conventional bacteriological methods and current molecular biological techniques for the etiological diagnosis of infective endocarditis (IE). SUBJECTS AND METHODS: Examinations were made in 53 patients treated at City Clinical Hospital Sixty-Four, Moscow Healthcare Department, in 2012-2015 who underwent simultaneous bacteriological and molecular biological (polymerase chain reaction (PCR) or PCR with further sequencing) examinations of blood or resected cardiac valve tissues...
2016: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28003590/multicenter-study-of-the-clinical-presentation-of-staphylococcus-lugdunensis-bacteremia-in-japan
#6
Yusuke Ainoda, Nozomi Takeshita, Ryota Hase, Takahiro Mikawa, Naoto Hosokawa, Ichiro Kawamura, Hanako Kurai, Masahiro Abe, Muneyoshi Kimura, Hideki Araoka, Takahiro Fujita, Kyoichi Totsuka, Kazuhisa Mezaki, Noritaka Sekiya, Norio Ohmagari
Staphylococcus lugdunensis (SL) is a highly pathogenic bacterium compared to other coagulase-negative Staphylococcus spp. (CoNS). However, in Japan, data for this pathogen are sparse, and the current prevalence of SL bacteremia is unknown.A prospective multicenter study across five facilities was performed to investigate the prevalence of SL in blood culture specimens. There were 3,284 patients with positive blood cultures, and 2,478 patients had bacteremia. Among patients with bacteremia, 7 patients (0.28%) had SL bacteremia...
December 22, 2016: Japanese Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28001173/patient-in-chronic-hemodialysis-with-right-atrial-mass-thrombus-fungal-endocarditis-or-atrial-myxoma
#7
Talita G Salani, Cynthia de Moura Borges, Carolina S Urbini, Patrícia Schincariol, Kélcia Rosana da Silva Quadros, Maria Almerinda Ribeiro-Alves, Rodrigo Bueno de Oliveira
We present the case report of a 19-year-old patient with chronic kidney disease due to chronic glomerulonephritis, in hemodialysis (HD) by central catheter, with the incidental finding of a mass of 28x16 mm in right atrium (RA). The diagnosis of thrombus, infective endocarditis or myxoma were considered. Given the context of immunosuppression and difficult access vascular therapeutic practice has proved complex. Although Doppler echocardiography suggested thrombus in RA, nuclear magnetic resonance imaging (MRI) indicated for the diagnosis of myxoma in RA...
December 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/27989071/broad-range-16s-rdna-pcr-on-heart-valves-in-infective-endocarditis
#8
Manica Müller Premru, Tatjana Lejko Zupanc, Tomislav Klokočovnik, Eva Ruzić Sabljić, Tjaša Cerar
BACKGROUND: Infective endocarditis (IE) is diagnosed by blood and/or resected valve cultivation and echocardiographic findings, as defined by the Duke criteria. Unfortunately, cultures may be negative due to prior antibiotic therapy or fastidious or slow-growing microorganisms. The study aim was to investigate the value of the broad-range polymerase chain reaction (PCR) in addition to blood and valve culture for the detection of causative microorganisms. METHODS: Between February 2012 and March 2015, valve samples from 36 patients undergoing cardiac surgery were analyzed; of these patients, 26 had a preoperative diagnosis of IE and 10 served as controls...
March 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27989050/seroprevalence-of-q-fever-in-patients-undergoing-heart-valve-replacement-surgery
#9
Owen Seddon, Reza Ashrafi, Jacqueline Duggan, Rhianydd Rees, Christine Tan, John Williams, Gail Carson, Brendan Healy
BACKGROUND: Q fever, caused by the rickettsia Coxiella burnetii, is a worldwide zoonotic disease with both acute and chronic manifestations. Endocarditis is the principal chronic manifestation. Q fever can easily be mistaken for degenerative valve disease due to its indolent presentation, the fastidious nature of the organism (routine cultures are negative), and the absence of a typical echocardiographic and macroscopic appearance for endocarditis. Prosthetic valve failure, with associated morbidity and mortality, have been described following unrecognized infections...
May 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27989048/complicated-infective-endocarditis-of-a-mechanical-aortic-valve-due-to-propionibacterium-acnes
#10
Eva De Caluwé, Jan Verwerft
Propionibacterium acnes is known to be a causative microorganism in low-grade and late prosthetic valve endocarditis. Here, the case is reported of a late, apparently culture-negative endocarditis of an aortic mechanical prosthesis, diagnosed to be caused by P. acnes after pan-bacterial polymerase chain reaction (PCR) on the explanted mechanical prosthetic valve. This endocarditis was complicated by an aortic root abscess; after surgical resection a ventricular septal defect (VSD) with overt right ventricular and multiple organ failure occurred...
May 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27984318/systemic-inflammatory-response-syndrome-is-not-an-indicator-of-bateremia-in-hemodialysis-patients-with-native-accesses-a-multicenter-study
#11
Daisuke Uchida, Sho Sasaki, Hiroo Kawarazaki, Masahito Miyamoto, Atsushi Nomura, Kenichiro Koitabashi, Hiroki Nishiwaki, Yugo Shibagaki
Bloodstream infection (BSI) in hemodialysis (HD) patients is often difficult to diagnose. Systemic inflammatory response syndrome (SIRS) is a sensitive predictor of BSI in the general population. We aimed to assess the usefulness of SIRS in predicting BSI in HD patients.We designed a multi-center retrospective observational study of adult (age > 18 years) HD patients who underwent 2 sets of blood cultures for suspected BSI at first hospital visit from August 2011 to July 2012. Clinical, biological, and microbial data were evaluated to evaluate SIRS as a predictor of BSI upon initial presentation to the hospital...
December 13, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27979420/procalcitonin-levels-in-bloodstream-infections-caused-by-different-sources-and-species-of-bacteria
#12
Sheng Tao Yan, Li Chao Sun, Hong Bing Jia, Wen Gao, Jian Ping Yang, Guo Qiang Zhang
OBJECTIVE: The aim of this study was to evaluate procalcitonin (PCT) diagnostic accuracy in discriminating gram-negative (GN) from gram-positive (GP) bloodstream infections and determining the relationship between PCT levels, infection sites, and pathogen types. METHODS: Clinical and laboratory data were collected from patients with blood culture (BC)-positive sepsis between January 2014 and December 2015. PCT levels at different infection sites were compared, as was the presence of GN and GP bloodstream infection...
December 10, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27920984/staphylococcus-lugdunensis-endocarditis-with-destruction-of-the-ventricular-septum-and-multiple-native-valves
#13
Celestine Ishiekwene, Monica Ghitan, Margaret Kuhn-Basti, Edward Chapnick, Yu Shia Lin
Staphylococcus lugdunensis (S. lugdunensis) is a coagulase negative staphylococcus (CoNS) that can cause destructive infective endocarditis. S. lugdunensis, unlike other CoNS, should be considered to be a pathogen. We report the first case of S. lugdunensis endocarditis causing ventricular septal defect and destruction of the aortic and mitral valves. A 53-year-old male with morbid obesity and COPD presented with intermittent fever and progressive shortness of breath for 2 weeks. Chest examination showed bilateral basal crepitations, and a grade 2 systolic murmur along the right sternal border...
2017: IDCases
https://www.readbyqxmd.com/read/27913565/a-24-year-old-male-with-a-painful-and-cold-lower-extremity
#14
Eric A Robinson, Zain I Khalpey, Rajesh Janardhanan
CLINICAL INTRODUCTION: A 24-year-old male presented to the emergency department with intense pain in his right lower extremity. He has a medical history significant for systemic lupus erythematosus and antiphospholipid syndrome. He also had four prior episodes of deep venous thromboses on rivaroxaban. The patient stated that early in the morning, he started to feel intense pain that started from his knee and progressed to his calf, with associated numbness and paraesthesia. On physical examination, the limb felt cold with absent right popliteal and dorsalis pedis pulses...
December 2, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27885468/staphylococcus-lugdunensis-infections-filling-in-the-gaps-a-3-year-retrospective-review-from-a-comprehensive-cancer-center
#15
Lior Nesher, Jeffery Tarrand, Roy F Chemaly, Kenneth Vi Rolston
OBJECTIVE: Staphylococcus lugdunensis is considered to be more aggressive than other coagulase-negative staphylococci (CoNS). There are gaps in knowledge regarding the importance of isolating S. lugdunensis from different sources and in different patient subsets. Our objective was to describe the spectrum, clinical manifestations, and outcomes of infections caused by S. lugdunensis in patients with cancer. METHODS: A retrospective review of all cancer patients from whom S...
November 24, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27847068/afebrile-pannus-induced-blood-culture-negative-mechanical-valve-endocarditis
#16
Seiji Matsukuma, Kiyoyuki Eishi, Kazuyoshi Tanigawa, Takashi Miura, Ichiro Matsumaru, Kazuki Hisatomi, Akira Tsuneto
The diagnosis of prosthetic valve endocarditis may be challenging in patients with an atypical clinical presentation. Virtually all infections associated with mechanical prosthetic valves are localized to the prosthesis-tissue junction at the sewing ring and are accompanied by tissue destruction around the prosthesis. Because the orifice of the mechanical prosthetic valve is made of metal and pyrolytic carbon, which do not enable the adherence of microorganisms, any vegetation originating from the interior of the valve orifice is usually rare...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27844027/prosthetic-valve-endocarditis-caused-by-bartonella-henselae-a-case-report-of-molecular-diagnostics-informing-nonsurgical-management
#17
Patricia Bartley, Emmanouil Angelakis, Didier Raoult, Rangarajan Sampath, Robert A Bonomo, Robin L P Jump
Identifying the pathogen responsible for culture-negative valve endocarditis often depends on molecular studies performed on surgical specimens. A patient with Ehlers-Danlos syndrome who had an aortic graft, a mechanical aortic valve, and a mitral anulloplasty ring presented with culture-negative prosthetic valve endocarditis and aortic graft infection. Research-based polymerase chain reaction (PCR)/electrospray ionization mass spectrometry on peripheral blood samples identified Bartonella henselae. Quantitative PCR targeting the16S-23S ribonucleic acid intergenic region and Western immunoblotting confirmed this result...
October 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27803825/native-mitral-valve-endocarditis-caused-by-neisseria-elongata-subsp-nitroreducens-in-a-patient-with-marfan-syndrome-first-case-in-italy-and-review-of-the-literature
#18
Parrinello Rossella, Carità Patrizia, Triolo Fabio Oreste, Trapani Renato, Grassedonio Emanuele, Argano Vincenzo, Novo Giuseppina, Vallone Silvana, Fasciana Teresa, Verdecchia Massimo, Giammanco Anna, Midiri Massimo, Novo Salvatore
Neisseria elongata (NE) is an aerobic Gram-negative organism that constitutes part of the commensal human normal oropharyngeal flora. Although previously considered not to be pathogenic, it has been recognized as an occasional cause of significant infections in humans. We report here the first case in Italy of infective endocarditis of a native prolapsing mitral valve in a patient with Marfan syndrome, caused by NE subspecies nitroreducens which has been rarely isolated from clinical specimens. The culprit organism has been confirmed by mass spectrometry directly from the positive blood culture, as previously reported...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/27781969/-a-blood-culture-containing-coagulase-negative-staphylococci-not-always-due-to-contamination
#19
E C F Wagenaar, P van Wijngaarden, C M Verduin, D Beelen, R W van Etten
Staphylococcus lugdunensis (SL) is a species belonging to the group of coagulase-negative staphylococci (CNS). It can cause severe infections such as endocarditis. Three cases of endocarditis caused by SL are presented. The first case describes a 71-year-old man with a fever and endogenous endophthalmitis. The second case describes delirium in an 87-year-old woman, thought to be due to pneumonia. The third case describes a 76-year-old man with an infection of unknown origin. In all cases, the first blood cultures drawn were positive for CNS and considered to be contaminated...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27777118/the-occurrence-of-infective-endocarditis-with-staphylococcus-lugdunensis-bacteremia-a-retrospective-cohort-study-and-systematic-review
#20
Lemuel R Non, Carlos A Q Santos
BACKGROUND: Staphylococcus lugdunensis is a coagulase-negative staphylococcus with similar virulence characteristics as S. aureus. Whether S. lugdunensis causes infective endocarditis (IE) in a similar proportion of cases as S. aureus (reported to be 12.6% in a definitive multicenter prospective study) is unclear. METHODS: We conducted a retrospective cohort study of adult patients with at least one blood culture positive for S. lugdunensis at our institution from January 2006 to December 2014...
October 21, 2016: Journal of Infection
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