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

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.