RT Journal Article
T1 Point-of-Care Ultrasound (POCUS) as an Extension of the Physical Examination in Patients with Bacteremia or Candidemia.
A1 López Palmero, Serafín
A1 López Zúñiga, Miguel Angel
A1 Rodríguez Martínez, Virginia
A1 Reyes Parrilla, Raul
A1 Alguacil Muñoz, Ana Maria
A1 Sánchez-Yebra Romera, Waldo
A1 Martín Rico, Patricia
A1 Poquet Catalá, Inmaculada
A1 Jiménez Guardiola, Carlos
A1 Del Pozo Pérez, Alfonso
A1 Lobato Cano, Ruben
A1 Lazo Torres, Ana Maria
A1 López Martínez, Gines
A1 Díez García, Luis Felipe
A1 Parrón Carreño, Tesifon
K1 bacteremia
K1 candidemia
K1 infective endocarditis
K1 point-of-care ultrasound (POCUS)
AB In general, transthoracic echocardiography (TTE) is the first diagnostic test used for patients with bacteremia or candidemia and clinical signs of Infective Endocarditis (IE). Point-of-care ultrasound (POCUS) may be used in addition to physical examination for the detection of structural heart disease and valve abnormalities. To determine the diagnostic accuracy of POCUS for the detection of signs suggestive of IE, including vegetation, valvular regurgitation, structural heart disease, hepatomegaly, splenomegaly and septic embolisms, in patients with bacteremia or candidemia. Observational, cross-sectional, multicenter study using convenience sampling. Six Spanish academic hospitals. Adult patients with bacteremia or candidemia between 1 February 2018 and 31 December 2020. The reference test, to evaluate vegetation, valvular regurgitation and structural heart disease, was transesophageal echocardiography (TEE). For patients who did not undergo TEE, transthoracic echocardiography (TTE) was considered the reference test. POCUS was performed by internists, while conventional echocardiography procedures were performed by cardiologists. In 258 patients, for the detection of valvular vegetation, POCUS had sensitivity, specificity, and positive and negative predictive values of 77%, 94%, 82% and 92%, respectively. For valvular regurgitation (more than mild), sensitivity was ≥76% and specificity ≥85%. Sensitivity values for the detection of hepatomegaly and splenomegaly were 92% and 92%, respectively, while those for specificity were 96% and 98%. POCUS could be a valuable tool, as a complement to physical examination, at the hospital bedside for patients with bacteremia or candidemia, helping to identify signs suggestive of IE.
SN 2077-0383
YR 2022
FD 2022-06-23
LK http://hdl.handle.net/10668/21304
UL http://hdl.handle.net/10668/21304
LA en
DS RISalud
RD Apr 10, 2025