Infective endocarditis: 'atypical' organisms can cause it

Clinical bottom line (level 4)

  1. Case-series have demonstrated pathological and microbiological evidence of 'atypical' organisms in patients with culture-negative infective endocarditis
Bayer et al: Circulation 1998; 98: 2936-2948
Expires October 2003

The study

Systematic review of hospital based case series, reports and autopsy reports of
  • Patients: culture-negative infective endocarditis
  • Outcome: demonstration of causative organism


    • Articles found in narrative review using not stated, 1981-1998 update (search terms: not stated )

    Selection criteria: not stated
    Appraisal criteria: not stated
    Articles excluded if: not stated


    The evidence

    • Serological testing is effective in detecting Chlamydia, Bartonella, Brucella spp and Coxiella burnetii.
    • Legionella and HACEK species may need prolonged or specialised incubation.
    • Fungi may appear only sporadically.

    Comments

    1. Taken from a narrative review on the investigation and management of infective endocarditis.

    Citation

    1. Bayer AS, Bolger AF, Taubert KA, et al: Diagnosis and Management of Infective Endocarditis and its Complications. Circulation 1998; 98: 2936-2948
    Contributor: Bob Phillips and Clare Wotton, October 2000
    Reviewer:

    Clinical Question.
    Patient suspected endocarditis
    Intervention or Exposure serological testing, prolonged incubation
    Outcome causative organism