Instant Endocarditis Diagnosis Using Point-of-Care Ultrasound (POCUS) in a Patient Diagnosed With Pneumonia

Abstract

Acute bacterial endocarditis is an acute febrile illness that spreads hematogenously and can be fatal if it is not treated in a timely fashion. A traditional physical examination has very limited sensitivity and specificity when diagnosing bacterial endocarditis. Point-of-care ultrasound (POCUS) during the physical exam can assist with the diagnosis by evaluating for valvular regurgitation or visible vegetation. In this case, a patient presented to the hospital with a cough and shortness of breath and was diagnosed with pneumonia. She did not improve with intravenous antibiotics and a POCUS exam revealed the diagnosis was in fact bacterial endocarditis and not pneumonia. This led to further imaging, which revealed an abdominal abscess. This highlights the importance of incorporating POCUS into the physical exam of any patient presenting with cardiopulmonary symptoms.

Efficacy of Handheld Ultrasound in Medical Education: A Comprehensive Systematic Review and Narrative Analysis

“…Handheld ultrasound devices can be vital in developing countries and other resourcelimited settings, often being the only available imaging devices. Ultraportable devices have already been used in emergency medicine [9,10], remote areas [11], disaster responses (e.g., the New Mexico Disaster Medical Assistance Team used handheld ultrasound machines to aid patient care, and this proved effective in making management decisions [12]), and military situations (wherein they are easy to use, valuable in discerning a diagnosis [13]), or they can act as an auxiliary to clinical examination at point-of-care examination [14][15][16][17].…”