Have you used Karius to work up fevers in the hospital when the source remains unknown?

This is a tricky question because Karius is an expensive test, which many experts believe should not be used for its negative predictive value (and I have anecdotally seen negative results where infection was still present, and infections/organisms detected of very unclear significance). I like to u...

Yes. It may be particularly useful in culture-negative infections. We always do it in consultation with an infectious disease specialist because some non-pathogens can come back positive.

We have a criterion for when this test can be sent, and it is not allowed for contexts where there isn’t evidence of localized infection somewhere. For example, pulmonary nodules concerning for IFI, or disseminated liver lesions, culture-negative endocarditis, we explicitly restrict use for FUO or f...

Yes. Not a first-line test, but helpful in FUOs when suspicion for infection is high. I have achieved etiological diagnosis in graft infections, culture-negative endocarditis, and culture/aspirate-negative discitis/vertebral OM. These are infections that require long-term antibiotics, and if possibl...