Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a history of persistent fever, chills, and night sweats. Reports recent onset of dyspnea on exertion, orthopnea, and palpitations. Denies recent dental procedures, IV drug use, or skin infections. Symptoms are associated with fatigue, malaise, and unintentional weight loss.
Clinical Examination Findings
Vitals: Febrile, tachycardic. CV: Grade III/VI diastolic decrescendo murmur heard best at the left sternal border, radiating to the apex. No signs of heart failure (JVD, peripheral edema). Skin: No Osler nodes, Janeway lesions, or splinter hemorrhages noted. Fundoscopy: No Roth spots.
Treatment Protocol
Initiate empiric IV antibiotic therapy pending blood culture results (e.g., Vancomycin + Ceftriaxone). Obtain serial blood cultures and transthoracic/transesophageal echocardiogram (TTE/TEE) to assess vegetation size and hemodynamic stability. Consult Cardiothoracic Surgery for evaluation of aortic valve replacement if complications arise.