Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a history of persistent fever, chills, and night sweats. Reports recent onset of dyspnea, fatigue, and orthopnea. Denies recent dental procedures or IV drug use. Symptoms suggestive of aortic valve endocarditis, including potential embolic phenomena or new-onset heart failure symptoms.
Clinical Examination Findings
Vitals: Febrile, tachycardic. HEENT: Conjunctival petechiae, Roth spots absent. CV: New or changing diastolic decrescendo murmur at the left sternal border consistent with aortic regurgitation. Skin: Osler nodes, Janeway lesions, or splinter hemorrhages absent. Extremities: No peripheral edema or clubbing.
Treatment Protocol
Initiate empiric IV antibiotic therapy pending blood culture results (e.g., Vancomycin + Ceftriaxone). Serial echocardiography (TTE/TEE) to monitor vegetation size and valve function. Consult Cardiothoracic Surgery for potential valve replacement if complications arise (e.g., severe regurgitation, heart failure, or persistent infection).