Laboratory Algorithm for Diagnosing Infective Endocarditis: From Blood Cultures to Molecular Testing
This review proposes a structured microbiologic and pathological diagnostic algorithm for infective endocarditis. Blood cultures remain the first-line test, with directed serology for Q fever and Bartonella recommended in culture-negative cases. Molecular methods including 16S rRNA gene PCR and Tropheryma whipplei PCR on resected valve tissue provide critical diagnostic yield when conventional cultures fail.
The original study
Laboratory Diagnosis of Infective Endocarditis.
- Authors
- Liesman RM, Pritt BS, Maleszewski JJ, Patel R
- Journal
- Journal of clinical microbiology
- Type
- Journal Article, Review, Research Support, Non-U.S. Gov't
- PMID
- 28659319
Original abstract
Infective endocarditis is life-threatening; identification of the underlying etiology informs optimized individual patient management. Changing epidemiology, advances in blood culture techniques, and new diagnostics guide the application of laboratory testing for diagnosis of endocarditis. Blood cultures remain the standard test for microbial diagnosis, with directed serological testing (i.e., Q fever serology, Bartonella serology) in culture-negative cases. Histopathology and molecular diagnostics (e.g., 16S rRNA gene PCR/sequencing, Tropheryma whipplei PCR) may be applied to resected valves to aid in diagnosis. Herein, we summarize recent knowledge in this area and propose a microbiologic and pathological algorithm for endocarditis diagnosis.