Open Access Highly Accessed Case report

Emergency department diagnosis of infective endocarditis using bedside emergency ultrasound

Dina Seif1*, Andrew Meeks1, Thomas Mailhot1 and Phillips Perera2

Author Affiliations

1 Department of Emergency Medicine, Los Angeles County + USC Medical Center, 1200 N. State St #1011, Los Angeles, CA, 90033, USA

2 Divison of Emergency Medicine, Stanford University Medical Center, 300 Pasteur Drive, Alway Building, M121, Stanford, CA, 94305, USA

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Critical Ultrasound Journal 2013, 5:1  doi:10.1186/2036-7902-5-1

Published: 11 February 2013

Abstract

Infective endocarditis is a challenging diagnosis that is rarely made in the emergency department. As the use of focused emergency ultrasound expands into more applications, including advanced echocardiography, the diagnosis of infective endocarditis may be made earlier, potentially leading to more timely treatment. We report a case of an ill-appearing patient presenting to the emergency department with an indwelling central venous catheter, a cardiac murmur, and necrotic toes, who was diagnosed with a large tricuspid vegetation and prominent tricuspid regurgitation on bedside emergency ultrasound. A cardiologist-performed echocardiogram confirmed these findings during the patient's hospital admission.

Keywords:
Emergency ultrasound; Infective endocarditis; Transthoracic echocardiography; Cardiac valvular vegetation; Cardiac valvular regurgitation; Cardiac shunt; Septic emboli