A 20-year-old healthy male presented to the emergency department with right arm pain
and fever for 1 week. He also had right calf and left thigh pain and dysuria. He was
given ceftriaxone and a cephalexin course at a local clinic for possible cellulitis
and urinary tract infection. His symptoms progressed. No recent travels or illicit
drug use. Upon presentation, he was tachycardic (110 beats pers min) and febrile (39.9°C).
Erythema, swelling, and tenderness were noted over the right upper arm, right anterior
thigh, and left posterior calf. Cardiac auscultation showed grade 3/6 systolic murmur.
The rest of the physical examination was unremarkable.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Blood culture-negative infective endocarditis: a worse outcome? Results from a large multicentre retrospective Spanish cohort study.Infect Dis. 2021; 53: 755-763
- Blood culture negative endocarditis: analysis of 63 cases presenting over 25 years.Heart. 2003; 89: 258-262
- A clinical study of culture-negative endocarditis.Medicine. 2003; 82: 263-273
- Infective endocarditis in the Western Cape Province of South Africa: a three-year prospective study.QJM. 2003; 96: 217-225
- Polymerase chain reaction diagnosis in culture-negative prosthetic valve methicillin-resistant Staphylococcus aureus endocarditis in a patient with chronic liver disease.Interact Cardiovasc Thorac Surg. 2004; 3: 240-242
- Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association.Circulation. 2015; 132: 1435-1486
- Clinical practice update on infectious endocarditis.Am J Med. 2020; 133: 44-49
- Modified Duke/European Society of Cardiology 2015 clinical criteria for infective endocarditis: time for an update?.Open Heart. 2022; 9e001856
Article info
Publication history
Published online: February 03, 2023
Accepted:
January 9,
2023
Received:
January 2,
2023
Publication stage
In Press Journal Pre-ProofFootnotes
Funding: None.
Conflicts of Interest: None.
Authorship: All authors had access to the data and a role in writing this manuscript.
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
