How long would you treat a patient with recent history of TAVR presenting with E faecalis bacteremia with unclear source with TEE showing thickened valves but no obvious vegetation?  

Treatment duration depends on other additional factors.TEE showed leaflet thickening- a non-specific finding, not a feature per Duke's major imaging criteria. Another feature to consider would be an associated new-onset valvular insufficiency that might increase the likelihood of IE. In such cases, ...

Without a known primary source, despite negative TEE, agree that we all have high clinical suspicion for endocarditis.Treat 2 weeks IV ampicillin/ceftriaxone. After that, the accumulating data on PO treatment of endocarditis (including prosthetic valve endocarditis) offers another nice option to ext...