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Infective Endocarditis — SCE Infectious Diseases MCQ

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HardBone & Joint InfectionInfective EndocarditisSCE Infectious Diseases

A patient with prosthetic-valve endocarditis has repeatedly negative routine blood cultures despite a large vegetation. Which first-line serological tests are particularly important?

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Correct answer: D — Coxiella burnetii phase-I IgG and Bartonella serology

The best answer is “Coxiella burnetii phase-I IgG and Bartonella serology”. Coxiella and Bartonella are leading causes of blood-culture-negative endocarditis and have established serological pathways; exposure history also guides testing for T. whipplei, fungi and other organisms. The ESC guideline covers blood-culture-negative endocarditis, antimicrobial strategy, oral step-down selection and surgical indications.

Reference: 2023 ESC Guidelines for infective endocarditis: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Endocarditis-Guidelines