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The Source of Recurrent Bacteremia Identified by Trans-esophageal Echocardiography

Frederick L. Porkolab, MD; David L. Weinbaum, MD; David B. Lerberg, MD; and John C. Phillips, MD
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Requests for Reprints: Frederick L. Porkolab, MD, Department of Medicine, The Western Pennsylvania Hospital, 4815 Liberty Avenue, Pittsburgh, PA 15224.

Current Author Addresses: Drs. Porkolab, Weinbaum, and Phillips: Department of Medicine, The Western Pennsylvania Hospital, 4815 Liberty Avenue, Pittsburgh, PA 15224.

Dr. Lerberg: Department of Surgery, The Western Pennsylvania Hospital, 4815 Liberty Avenue, Pittsburgh, PA 15224.

Ann Intern Med. 1990;112(8):628-629. doi:10.7326/0003-4819-112-8-628
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This excerpt has been provided in the absence of an abstract.

Patients with Staphylococcus aureus bacteremia can be divided into two groups (1). Patients in the group with a recognizable primary site of infection tend to be older with significant, underlying medical disorders and recent hospitalizations. These patients are more easily cured. Patients in the other group, with no identifiable site of primary infection, are usually younger, commonly abuse intravenous drugs, and often have endocarditis.

Conventional transthoracic echocardiography can help in the positive diagnosis of endocarditis. However, it has limited sensitivity, especially for smaller vegetations. We report the case of a patient whose source of endocarditis was revealed only by trans-esophageal


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