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Identification of Cardiobacterium hominis by Broad-Range Bacterial Polymerase Chain Reaction Analysis in a Case of Culture-Negative Endocarditis
Simo Nikkari, MD, PhD;
Robert Gotoff, MD;
Paul P. Bourbeau, PhD;
Robert E. Brown, MD;
Nazmi R. Kamal, MD;
David A. Relman, MD
Arch Intern Med. 2002;162:477-479.
Culture-negative bacterial endocarditis may be attributed to fastidious
microorganisms, prior institution of antibiotic treatment, or both. We describe
a case of culture-negative endocarditis in which a modified Steiner stain
revealed bacterial structures in the resected heart valve material. Prompted
by this finding, broad-range polymerase chain reaction (PCR) amplification
of small-subunit ribosomal DNA (16S rDNA) was performed, and Cardiobacterium hominis sequences were detected. This case demonstrates
the usefulness of both the Steiner stain and broad-range direct molecular
amplification as supplemental diagnostic tools in identification of otherwise
unexplained infections.
From the Palo Alto Veterans Affairs Health Care System, Palo Alto,
Calif, and the Departments of Microbiology & Immunology and Medicine,
Stanford University, Stanford, Calif (Drs Nikkari and Relman); and Geisinger
Medical Center, Danville, Pa (Drs Gotoff, Bourbeau, Brown, and Kamal). Dr
Nikkari is now with MoBiDiag Oy, Biomedicum, Helsinki, Finland.
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