Criteria of Kaasch for Echocardiography to Exclude Infectious Endocarditis in a Patient with Nosocomial Staphylococcus aureus Bacteremia

 

Patient selection: nosocomial bacteremia with Staphylococcus aureus

 

Criteria for TEE:

(1) prolonged bacteremia (> 4 days after first positive blood culture)

(2) presence of permanent intracardiac device (prosthetic heart valve, other)

(3) hemodialysis dependency

(4) spinal infection (vertebral osteomyelitis, epidural abscess, subdural abscess, intraspinal abscess)

(5) nonvertebral osteomyelitis

 

A patient with one or more of the criteria should have TEE to exclude infectious endocarditis.

 

TEE should be considered if no criteria are present if the clinician is suspected of having infectious endocarditis based on clinical findings.

 

An adequate set of follow-up blood cultures 2 to 4 days after the first positive blood culture can be used to exclude persistent bacteremia.