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Hi #IDFellows and #IDTwitter, back with another case: 63F h/o ESRD on HD p/w fever. Blood cx positive for MSSA x 4 days. Blood cx clear on day 5 with Rx Cefazolin. TTE on HD2 without vegetations. What is the best next step?
1/ Let’s talk about when to get a TEE for Staph aureus bacteremia (SAB) to identify infective endocarditis (IE)!
This is a #IDControversy for #IDFellows & #IDTwitter. Let's examine the evidence.
This is a #IDControversy for #IDFellows & #IDTwitter. Let's examine the evidence.
2/ For background, SAB has a high mortality (~20%); determining the presence of IE changes the duration of treatment to 6+ weeks.
The sensitivity of TTE for IE is ~60-65% compared to ~95% for TEE. But TEE has associated costs & procedural risks (sedation, esophageal perf, etc)
The sensitivity of TTE for IE is ~60-65% compared to ~95% for TEE. But TEE has associated costs & procedural risks (sedation, esophageal perf, etc)
