{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T03:21:45Z","timestamp":1792639305489,"version":"4.5.0"},"reference-count":27,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>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 \u226576% and specificity \u226585%. 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.<\/jats:p>","DOI":"10.3390\/jcm11133636","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T21:25:00Z","timestamp":1656019500000},"page":"3636","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Point-of-Care Ultrasound (POCUS) as an Extension of the Physical Examination in Patients with Bacteremia or Candidemia"],"prefix":"10.3390","volume":"11","author":[{"given":"Seraf\u00edn","family":"L\u00f3pez Palmero","sequence":"first","affiliation":[{"name":"Internal Medicine Department, Torrec\u00e1rdenas University Hospital, 04009 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel Angel","family":"L\u00f3pez Z\u00fa\u00f1iga","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Virgen de las Nieves University Hospital, 18014 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Rodr\u00edguez Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Torrec\u00e1rdenas University Hospital, 04009 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul","family":"Reyes Parrilla","sequence":"additional","affiliation":[{"name":"Cardiology Department, Torrec\u00e1rdenas University Hospital, 04009 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Maria","family":"Alguacil Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Toledo University Hospital, 45600 Toledo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8546-1989","authenticated-orcid":false,"given":"Waldo","family":"S\u00e1nchez-Yebra Romera","sequence":"additional","affiliation":[{"name":"Microbiology Department, Torrec\u00e1rdenas University Hospital, 04009 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Mart\u00edn Rico","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Marina Salud D\u00e9nia Hospital, 03700 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inmaculada","family":"Poquet Catal\u00e1","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Marina Salud D\u00e9nia Hospital, 03700 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1695-0911","authenticated-orcid":false,"given":"Carlos","family":"Jim\u00e9nez Guardiola","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Vega Baja Orihuela Hospital, 03314 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Del Pozo P\u00e9rez","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Vega Baja Orihuela Hospital, 03314 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruben","family":"Lobato Cano","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Virgen de las Nieves University Hospital, 18014 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Maria","family":"Lazo Torres","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Torrec\u00e1rdenas University Hospital, 04009 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gines","family":"L\u00f3pez Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Torrec\u00e1rdenas University Hospital, 04009 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Felipe","family":"D\u00edez Garc\u00eda","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Torrec\u00e1rdenas University Hospital, 04009 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0219-4745","authenticated-orcid":false,"given":"Tesifon","family":"Parr\u00f3n Carre\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Medicine, Almer\u00eda University, 04120 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/S0140-6736(15)00067-7","article-title":"Infective endocarditis","volume":"387","author":"Cahill","year":"2016","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1161\/CIR.0000000000000296","article-title":"Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications","volume":"132","author":"Baddour","year":"2015","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.eimc.2011.11.005","article-title":"La endocarditis infecciosa en el siglo xxi: Cambios epidemiol\u00f3gicos, terap\u00e9uticos y pron\u00f3sticos","volume":"30","author":"Almirante","year":"2012","journal-title":"Enferm. 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