Other minor diagnostic criteria for IE are much
more difficult to appreciate in children, including
vascular phenomena and immunologic phenomena.
In fact, no children in this study had any of these
clinical findings suggestive of endocarditis. This high
rate of clinically occult IE emphasizes the need for
echocardiographic screening among most children
who develop SAB, particularly if they have congenital
heart disease and/or persistently positive blood
cultures.