Blood Cultures in ED Adults
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þ Blood cultures in the ED
 - aren't very useful in patients well enough to go home.
   [Eisenberg JM, Rose JD, Weinstein AJ. Routine blood cultures from
   febrile outpatients. Use in detecting bacteremia. JAMA 1976 Dec
   20;236(25):2863-5.] Abstract: <ID-BlooA.TXT -Eisenberg>
 - mostly show pneumococcus
 - are useful mostly in those adults with risks for occult bactermia vs.
   subacute bacterial endocarditis (SBE):
  + HIV
  + malignancy
  + recent chemo
  + steroid use
  + sickle cell disease
  + nursing home residence
  + hospital stays within the past 14 days
   [Chalasani NP et al. Clinical utility of blood cultures in adult
   patients with community-acquired pneumonia without defined underlying
   risks. Chest 108(4):932, October 1995.] Abstract: <ID-BlooA.TXT -Chalasani>
  + history of rheumatic fever or other valvular disease
   [Sklar DP, Rusnak R. The value of outpatient blood cultures in the
   emergency department. Am J Emerg Med 1987 Mar;5(2):95-100.]
   Abstract:  <ID-BlooA.TXT -Sklar> (very small number of cases.)