Even in S. aureus bacteremia from a known extracardiac source, such as an infected joint or joint prosthe- sis, TEE might be considered, given known cases of seeding of valve tissue in this type of setting. Possible exceptions are patients who have no underlying cardiac predisposing conditions or clinical signs of IE whose fever and bacteremia resolve within 72 hours after removal of a likely CLINICAL STATEMENTS AND GUIDELINES infected focus (such as intravascular catheter removal). In the absence of 1) prolonged bac- teremia lasting >4 days, 2) a permanent intra- cardiac device, 3) hemodialysis dependency, or 4) spinal infection or nonvertebral osteomyelitis, the risk of IE is relatively low, and routine TEE may not be necessary.22,53,54,74 12.3. Medical Therapy Recommendations for Medical Therapy for IE Referenced studies that support the recommendations are summarized in Online Data Supplement 42. 