Question

a 42-year-old man with a past medical history of hypertension presents with intermittent fever of 6 weeks duration. he has an associated cough, dyspnea, anorexia, arthralgias, abdominal pain, diarrhea, a widespread rash throughout his body, and back pain. he has come to see you because he has experienced acute left upper and lower extremity weakness and painless hematuria since this morning. he denies chills, a history of travel, sick or confined contacts, exposure to animals, bites, stings, cigarette smoking, otalgia, sore throat, swollen glands, drug use, dysuria, preceding gi or gu infections, previous surgeries, or sexual contact in the past year. his physical exam is remarkable for fever, a generalized petechial rash and petechiae of the mucous membranes, dark red linear lesions of the nailbeds, tender subcutaneous nodules of the digital pads, and nontender maculae on the palms and soles. his heart is notable for a new harsh, medium pitched pansystolic murmur at the apex with radiation to axilla, reduced strengths to the left upper and lower extremities, and splenomegaly. question: what is the most likely diagnosis?

Answer 1

A 42-year-old man with past medical history of hypertension has intermittent fever of 6 weeks and has cough, anorexia, abdominal pain, a widespread rash, then diagnosis is : infective endocarditis.

What is infective endocarditis?

Endocarditis is life-threatening inflammation of the inner lining of the  chambers and valves of heart and the lining is called endocardium. Endocarditis is caused by an infection. Bacteria, fungi or any other germs gets into bloodstream and attach to the damaged areas in the heart.

Acute bacterial endocarditis is caused by staphylococcus aureus bacteria and sometimes also by the bacterial strains brucella and listeria. This form of infective endocarditis is likely to affect normal heart valves as compared to other forms.

To know more about infective endocarditis, refer

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