Clinical Observation
February 25, 2002

Identification of Cardiobacterium hominis by Broad-Range Bacterial Polymerase Chain Reaction Analysis in a Case of Culture-Negative Endocarditis

Author Affiliations

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.


Copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2002

Arch Intern Med. 2002;162(4):477-479. doi:10.1001/archinte.162.4.477

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.