Abstract
The diagnosis of blood culture negative endocarditis is still a problem. Fastidious bacteria such as bartonella and coxiella are responsible for cases of blood culture negative endocarditis, the identification of which is mainly based on serological and DNA studies only available in specialised centres. Therefore, a routine technique is needed in surgical pathology laboratories to detect these bacteria in cardiac valve tissue sections. This report describes a staining technique, the Giménez stain, feasible and sensitive in detecting bartonella and coxiella in two cases of blood culture negative endocarditis.
Key Words: endocarditis • bartonella • coxiella
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Figure 1 (A) Detection of bacteria in a case of Bartonella quintana endocarditis using the Giménez stain. The bacteria (arrows) appear as small intracellular rods stained pink/red. (B) Detection of bacteria in the inflammatory infiltrate in a case of Coxiella burnetti endocarditis using Giménez stain. The bacteria (arrows) are stained pink/red, contrasting with the background. (C) Detection of bacteria using Giménez stain in a case of Gram stain negative Staphylococcus epidermidis aortic endocarditis after prolonged antibiotic treatment.