HANDOC Score (Echo Need in Strep Bacteremia)
HANDOC score (Bai 2020): murmur, aetiology (species group), ≥ 2 positive cultures, symptom duration ≥ 7 days, single species, and community acquisition identify non-beta-hemolytic-streptococcal bacteremia warranting echocardiography (≥ 3).
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Auscultated murmur
- Yes
- Aetiology
- S. mutans / bovis / sanguinis group (+1)
- ≥ 2 positive cultures
- Yes
- Duration of symptoms ≥ 7 days
- No
- Single species isolated
- No
- Community acquisition
- No
Result: HANDOC score 3 — echocardiography recommended (>= 3).
The tool opens with these values already filled in. Replace them with your own.
What the result means
- <= 2
- Echocardiography can be omitted.
- >= 3
- Echocardiography recommended. Murmur, aetiology, >= 2 cultures, duration >= 7 d, one species, community-acquired. A decision rule, not an imaging order.
What you enter
- Auscultated murmur
- Aetiology (species group)
- ≥ 2 positive cultures
- Duration of symptoms ≥ 7 days
- Single species isolated
- Community acquisition
How this is calculated
Sunnerhagen T, Tornell A, Vikbrant M, Nilson B, Rasmussen M. HANDOC: a handy score to determine the need for echocardiography in non-beta-hemolytic streptococcal bacteremia. Clin Infect Dis. 2018;66(5):693-698. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.