Examination by heart catheter

Question

My son, 30 years old, advanced CF, runs an increased temperature of about 37.8 degree Celsius in the evenings. His doctor obviously does not attribute this to pneumonia. He rather wants to search for bacteria on the heart by heart catheter. I never heart of anything like that in connection with CF. Therefore I am sceptical and actually opposed to such an examination. The doctor, however, thinks it is absolutely necessary. (During IVs my son’s body temperature is normal and the CRP drops drastically.)
I request a clear and open sentence if this invasive examination is in fact indicated.
Thank you very much,

With kind regards

Answer

Dear Mrs. Schmitt,
a slightly increased temperature may indeed be caused by endocarditis, that is an inflammation of the cardiac valves. This does not occur frequently in CF, but it may occur, of course. You would search for germs by blood cultures and have a look at the cardiac valves - by ultrasonic diagnostic from the outside (by ultrasonic cardiography) as well as from the inside with a tube through the oesophagus (oesophageal ultrasonic diagnostic of the heart). Thus you can asses the valves very well and perceive any vegetation of bacteria which might be sitting on the valves. Only after these examinations have been finished you would examine the heart by catheter, if at all.
With kind regards,
Prof. Joachim Bargon

07.07.2008