Transesophageal Echocardiography (TEE) in the Evaluation of Infective Endocarditis

Tricuspid Valve Endocarditis with Septic Pulmonary Emboli in a Drug Addict

“…TEE imaging is more sensitive to detect vegetations than TTE imaging, especially in case of abscesses, and associated left-sided involvement. 4) In our case, TEE was proven the best examination technique to diagnose right-sided endocarditis, clearly recognizing the tricuspid valve vegetation. In summary, the combination of typical right-sided echocardiographic structures and positive blood cultures can be considered as major criteria for right-sided endocarditis.…”

Methicillin-resistant Staphylococcus aureus prosthetic aortic valve endocarditis with paravalvular abscess treated with daptomycin

“…Current sensitivity and specificity for transthoracic echocardiography versus transesophageal echocardiography are 50% and 90% versus 90% and 92%, respectively. 7,8 Daptomycin proved to be lifesaving in this patient, with MRSA PVE with a paravalvular abscess and no response to vancomycin therapy, who refused surgical therapy. Daptomycin is a potent agent against resistant gram-positive pathogens (eg, MRSA and VRE).…”

Infective Endocarditis: An Update on the Role of Echocardiography

“…It may be important to note that as patients present earlier in the course of illness, many of the associated clinical signs may be absent [11]. The echocardiographic findings that are considered to be major criteria for the diagnosis of endocarditis include 1) the presence of a vegetation, defined as mobile echo-dense mass, implanted in a valve or mural endocardium in the trajectory of a regurgitant jet or implanted in prosthetic material without alternative anatomic explanation; 2) presence of abscesses; or 3) presence of a new dehiscence of a prosthesis [10,12]. Other abnormal echocardiographic findings not fulfilling these definitions are considered minor criteria.…”