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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.

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.

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