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Article

Point-of-Care Ultrasound (POCUS) as an Extension of the Physical Examination in Patients with Bacteremia or Candidemia

1
Internal Medicine Department, Torrecárdenas University Hospital, 04009 Almería, Spain
2
Infectious Diseases Department, Virgen de las Nieves University Hospital, 18014 Granada, Spain
3
Cardiology Department, Torrecárdenas University Hospital, 04009 Almería, Spain
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Internal Medicine Department, Toledo University Hospital, 45600 Toledo, Spain
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Microbiology Department, Torrecárdenas University Hospital, 04009 Almería, Spain
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Internal Medicine Department, Marina Salud Dénia Hospital, 03700 Alicante, Spain
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Internal Medicine Department, Vega Baja Orihuela Hospital, 03314 Alicante, Spain
8
Internal Medicine Department, Virgen de las Nieves University Hospital, 18014 Granada, Spain
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Infectious Diseases Department, Torrecárdenas University Hospital, 04009 Almería, Spain
10
Department of Medicine, School of Medicine, Almería University, 04120 Almería, Spain
*
Author to whom correspondence should be addressed.
Academic Editor: Manuel Martínez-Sellés
J. Clin. Med. 2022, 11(13), 3636; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11133636
Received: 11 May 2022 / Revised: 20 June 2022 / Accepted: 21 June 2022 / Published: 23 June 2022
(This article belongs to the Section Cardiology)
Background: 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. Objective: 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. Design: Observational, cross-sectional, multicenter study using convenience sampling. Setting: Six Spanish academic hospitals. Patients: Adult patients with bacteremia or candidemia between 1 February 2018 and 31 December 2020. Measurements: 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. Results: 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%. Conclusion: 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. View Full-Text
Keywords: point-of-care ultrasound (POCUS); bacteremia; candidemia; infective endocarditis point-of-care ultrasound (POCUS); bacteremia; candidemia; infective endocarditis
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MDPI and ACS Style

López Palmero, S.; López Zúñiga, M.A.; Rodríguez Martínez, V.; Reyes Parrilla, R.; Alguacil Muñoz, A.M.; Sánchez-Yebra Romera, W.; Martín Rico, P.; Poquet Catalá, I.; Jiménez Guardiola, C.; Del Pozo Pérez, A.; Lobato Cano, R.; Lazo Torres, A.M.; López Martínez, G.; Díez García, L.F.; Parrón Carreño, T. Point-of-Care Ultrasound (POCUS) as an Extension of the Physical Examination in Patients with Bacteremia or Candidemia. J. Clin. Med. 2022, 11, 3636. https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11133636

AMA Style

López Palmero S, López Zúñiga MA, Rodríguez Martínez V, Reyes Parrilla R, Alguacil Muñoz AM, Sánchez-Yebra Romera W, Martín Rico P, Poquet Catalá I, Jiménez Guardiola C, Del Pozo Pérez A, Lobato Cano R, Lazo Torres AM, López Martínez G, Díez García LF, Parrón Carreño T. Point-of-Care Ultrasound (POCUS) as an Extension of the Physical Examination in Patients with Bacteremia or Candidemia. Journal of Clinical Medicine. 2022; 11(13):3636. https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11133636

Chicago/Turabian Style

López Palmero, Serafín, Miguel A. López Zúñiga, Virginia Rodríguez Martínez, Raul Reyes Parrilla, Ana M. Alguacil Muñoz, Waldo Sánchez-Yebra Romera, Patricia Martín Rico, Inmaculada Poquet Catalá, Carlos Jiménez Guardiola, Alfonso Del Pozo Pérez, Ruben Lobato Cano, Ana M. Lazo Torres, Gines López Martínez, Luis F. Díez García, and Tesifon Parrón Carreño. 2022. "Point-of-Care Ultrasound (POCUS) as an Extension of the Physical Examination in Patients with Bacteremia or Candidemia" Journal of Clinical Medicine 11, no. 13: 3636. https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11133636

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