Echocardiography Strategy for Candidemia

Diagnostic Performance

TEE achieves >90% sensitivity for detecting intracardiac lesions associated with infective endocarditis, compared to 75% for TTE, as recommended by the American College of Radiology 1, 2
TEE has up to 98.6% negative predictive value in suspected infective endocarditis, according to the American College of Radiology 1, 3

If clinical suspicion of infective endocarditis persists after a negative TEE, repeat TEE after 3-5 days, as suggested by the American Heart Association, publisher of Circulation 5
A negative TEE never completely rules out infective endocarditis, as stated by the European Society of Cardiology, publisher of the European Heart Journal 2

Intracardiac abscess detected on echocardiography is an independent predictor of both in-hospital mortality and 1-year mortality, according to the American College of Radiology 1, 7, 8, 4
Valve perforation on echocardiography independently predicts 1-year mortality, as reported by the American College of Radiology 1, 4
Left ventricular ejection fraction <40% combined with intracardiac abscess predicts in-hospital mortality, according to the American College of Radiology 1, 4