A 43-year-old man is admitted with acute onset of right sided hemiplegia and dysarthria. He had been in excellent health until one month previously when he presented with shortness of breath and was diagnosed with acute pulmonary emboli and adenocarcinoma of the lung. He was begun on eliquis and chemotherapy was deferred pending genetic testing.

The patient lives with his wife and 2 children in Chicago. He works as a municipal bus driver. He denies pet or animal exposure. On presentation, he is afebrile. Exam is notable for poor dentition and dense right hemiplegia.

CT head confirmed a left middle cerebral artery infarct.

TTE confirms a 6x9 mm mass on the mitral valve.

Blood cultures x3 sets taken prior to initiation of antibiotics are no growth at 5 days.

What is the most probable cause of endocarditis in this patient?

A. T whipplei

B. Mycobacterium chimaera

C. Bartonella henselae

D. Hypercoaguable state

E. Coxiella burnetii

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Episode ID: 1000668866844

GUID: 954d5456-0ca5-4dea-a84c-bf95ff10f969

Release Date: 09/09/2024, 15:30:00