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Staphylococcus aureus bacteremia — ABIM Board MCQ

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ModerateInfectious DiseaseStaphylococcus aureus bacteremiaABIM Board

A 52-year-old man receiving hemodialysis through a tunneled catheter has fever and rigors. Two sets of blood cultures grow methicillin-susceptible Staphylococcus aureus. The catheter is removed and cefazolin is started. He becomes afebrile after 24 hours. Transthoracic echocardiography is technically limited and shows no vegetation. Which of the following is the most appropriate management?

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Correct answer: E — Transesophageal echocardiography and repeat blood cultures

S aureus bacteremia requires documentation of blood culture clearance and evaluation for endocarditis, often with transesophageal echocardiography in high-risk patients such as those on hemodialysis. Short oral therapy is inadequate.

Reference: IDSA Staphylococcus aureus Bacteremia/Endocarditis Guidance