**4.1. Non-invasive methods**

Imaging using positron emission tomography (PET) scanning has been utilized to diagnose a case of *T. whipplei* endocarditis [63]. The infected prosthetic valve was subsequently removed providing material for PCR-based methods to confirm the diagnosis, but the impetus to remove the valve came from the PET scan. Four-dimensional cardiac MRI was used to better define valvular damage and diagnose aortic valve endocarditis in a case of *C. bur‐ netti* CNE in a patient with exposure to domesticated buffalos and positive serologies [64]. PCR combined with electrospray ionization mass spectrometry (PCR/ESI-MS) methods have been applied to detect pathogens in blood cultures in patients already receiving antibiotics and made a diagnosis in 41 out of 410 cases, although not specifically in persons with CNE [65]. Broad range PCR on blood culture specimens has also been utilized [2]. Serum galactomannan and β-1,3-D-glucan have already been mentioned as serum diagnostic tests for fungal CNE [2, 61, 62].
