Impact of serology and molecular methods on improving the microbiologic diagnosis of infective endocarditis in Egypt

Abstract

Our data underline the role of serologic and molecular tools for the diagnosis of blood culture-negative endocarditis.

Gender differences in clinical features and complications of infective endocarditis: 11-year experience of a single institute in Egypt

“…This is a subgroup analysis of an IE registry in a tertiary care facility for 11 years in which we studied the main differences in IE features and management between both genders. The main registry report and subgroup reports were previously published [13,[22][23][24][25][26][27][28]. Differences in offering diagnostic and therapeutic healthcare services based on gender have been a major worldwide concern over the years [29][30][31][32].…”

Culture Negative Endocarditis: Advances in Diagnosis and Treatment

“…PCR combined with electrospray ionization mass spectrometry (PCR/ESI-MS) methods have been applied to detect pathogens in blood cultures in patients already receiving antibiotics and made a diagnosis in 41 out of 410 cases, although not specifically in persons with CNE [65]. Broad range PCR on blood culture specimens has also been utilized [2]. Serum galactomannan and β-1,3-D-glucan have already been mentioned as serum diagnostic tests for fungal CNE [2,61,62].…”

“…have been described rarely as a cause of CNE [9,21] including Gemella burgeri tricuspid valve endocarditis [26] and Gemella hemolysans prosthetic valve endocarditits identified by PCR of prosthetic valve material and requiring implantation of a total artificial heart as a bridge to transplantation [27]. Brucella mellitensis is another unusual pathogen associated with culture-negative endocarditis [2], especially in regions of the world where consumption of unpasteurized milk (cow, goat and sheep) occurs. In one series of six patients subsequently found to have Brucella endocarditis, only two patients had blood cultures that revealed the diagnosis [28].…”

“…[59,60] are the most widely reported. Commercial tests that detect fungal wall antigens such as galactomannan [2,61,62] and β-1,3-D-glucan [62] can show good sensitivity and specificity in diagnosis of fungal CNE. Jinno et al [56] reported negative urine Histoplasma antigen results in their patient with H. capsulatum CNE, with diagnosis based on valvular pathology and tissue culture.…”

“…Culture-negative endocarditis (CNE) is one of the most challenging infectious diseases clinical syndromes both diagnostically and therapeutically. The prevalence of CNE varies widely in various modern series: it is estimated that on average, in 20% (range 5-71%) of echocardiographically evident endocarditis, both native and prosthetic valve, blood cultures do not yield a specific pathogen [1][2][3][4][5][6][7]. The morbidity but not necessarily mortality associated with CNE is higher than in instances where a specific pathogen is found, primarily due to the increased burden of diagnostic testing, delays in administration of antibiotics and the extended use of broad spectrum anti-microbial agents [8].…”