PRESIDIO HOSPITAL | Caltanissetta, Italy1
A T2Bacteria result facilitated the diagnosis of infective endocarditis that led to the rapid initiation of targeted antibiotic therapy in a critically ill patient with prosthetic valve endocarditis. Fast species ID enabled targeted treatment 8 days before blood culture results were available.
Patient Presentation
The patient was admitted with fever, asthenia, myalgia, and a history of aortic valve replacement and diabetes. On the third day the patient had decompensation with hyperglycemia, hypokalemia, anuria, and hypotension refractory to fluids and vasopressors.
Evaluation and Treatment Decision
Day 3
Complete system evaluation including chest X-ray, transthoracic echocardiogram, cultures (BAL, blood), T2Bacteria ordered, and broad-spectrum antibiotics administered (ciprofloxacin, daptomycin, linezolid)
WBC 15.2 103/uL, PCT 35.2 ug/L, T2Bacteria test positive for Staphylococcus aureus, positive Osler and Janeway lesions
Antibiotic therapy changed (vancomycin, rifampin, gentamicin) for suspected Staphylococcus aureus prosthetic valve endocarditis.
Day 6
Transthoracic echocardiogram positive for mobile vegetations
Day 11
Anaerobic blood culture positive for Staphylococcus aureus
1. Federico, A., Sicily Medical Education Forum. 2022