Endocarditis: effects of routine echocardiography during Gram-positive bacteraemia

F. Vos, C. Bleeker-Rovers, P. Sturm, P. Krabbe, A. van Dijk, W. Oyen and B. Kullberg

Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. f.vos@aig.umcn.nl


Despite firm recommendations to perform echocardiography in high-risk patients with Gram-positive bacteraemia, routine echocardiography is not embedded in daily practice in many settings. The aim of this study was to evaluate whether a regime including routine echocardiography results in better outcome.A total of 115 patients with Gram-positive bacteraemia and at least one risk factor for developing metastatic infection were prospectively included. Routine echocardiography was advocated and facilitated in these patients. Results were compared with a matched historical control group of 230 patients in whom echocardiography was performed at the discretion of the attending physician. Endocarditis was diagnosed according to the Duke criteria.Echocardiography was performed more often in the study group (82 vs 27\%, p.