Cardiac Point of Care Ultrasound (POCUS) Used to Diagnose Infective Endocarditis Following Multiple Negative Echocardiograms
Bibliographic record
Abstract
Infective endocarditis (IE) is a life-threatening condition often diagnosed using the modified Duke’s criteria, including bacteremia and pathognomonic echocardiographic findings. However, up to 30% of cases yield inconclusive results with transthoracic echocardiograms (TTE) or transesophageal echocardiograms (TEE). We present a case of a 68-year-old man with methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia and recurrent fevers, in which multiple echocardiograms failed to detect valvular vegetations. However, an advanced cardiac point of care ultrasound (POCUS) examination identified a vegetation on the aortic valve, later confirmed by TTE and TEE. Although generalization is limited due to operator expertise and patient characteristics, this case demonstrates the utility of advanced cardiac POCUS in diagnosing IE in critically ill patients with negative initial echocardiograms. Incorporating advanced cardiac POCUS into routine diagnostic workflows may improve diagnostic accuracy and patient outcomes. Increasing use of advanced cardiac POCUS also highlights the importance of expanding proficiency among intensivists.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".