1st-order laboratory parameters-obligatory laboratory tests.
- Small blood count [leukocytosis/increase in white blood cells in blood]
- Differential blood count [left shift/increased neutrophilic rod-nucleated granulocytes (rod-nucleated neutrophils) or their progenitor cells in peripheral blood]
- Inflammatory parameters – CRP (C-reactive protein).
- Electrolytes – sodium, potassium, calcium.
- Urine status (rapid test for: Nitrite, protein, hemoglobin, erythrocytes, leukocytes, urobilinogen) incl. sediment, if necessary urine culture (pathogen detection and resistogram, that is, testing suitable antibiotics for sensitivity / resistance).
- Renal parameters – urea, creatinine, possibly cystatin C or creatinine clearance [retention parameters may be increased].
- Blood cultures (BK; at least 3-BK pairs; timing of blood collection plays a minor role and should not delay the start of urgent calculated antibiotic therapy; BK at least 2 weeks incubate! Collection independent of fever due tocontinuous bacteremia) – most common pathogens are: Streptococci, Enterococci; Anaerobes; Fungi (Candida); Brucella; furthermore AK against cardiotropic pathogens such as:
- 1st stage: adenoviruses, coxsachie viruses, echo viruses, influenza viruses, parainfluenza viruses.
- 2nd stage: borrelia, cytomegalovirus (CMV), malaria, mumps viruses, Q fever, group A streptococci, toxoplasma, trichinae, trypanosomes.
Laboratory parameters 2nd order – depending on the results of the history, physical examination and mandatory laboratory parameters – for differential diagnostic clarification.
- Diagnosis in culture-negative endocarditis (see above):
- Histology (fine tissue diagnosis): e.g., of biopsies (tissue sample) of peripheral emboli (occlusion of a blood vessel).
- PCR: Tropheryma whippelii, Bartonella spp.
- In case of surgery: examine valve material necessarily ( microbiological, PCR; histological).
- Serological tests: e.g. for Bartonella spp., Brucella spp. Coxiella burnetii (Cave: cross-reactivity (eg Coxiella burnetii / Chlamydia, Bartonella).
- Coagulation parameters – PTT, Quick
- Thyroid parameters – TSH, fT3, fT4
- Highly sensitive cardiac troponin T (hs-cTnT) or troponin I (hs-cTnI) – in suspected myocardial infarction (heart attack).
