A 32-year-old woman with a 6-year history of systemic lupus erythematosus (SLE) presents to the emergency department with a 2-week history of progressive dyspnea, low-grade fever (38.1°C), and malaise. On cardiovascular examination, a new early diastolic decrescendo murmur is heard at the left sternal border. Transthoracic echocardiography reveals small, friable vegetations on the aortic valve leaflets with mild aortic regurgitation and preserved left ventricular ejection fraction (58%). Blood cultures obtained on admission and repeated 48 hours later are negative. Serum complement levels are low, and anti-dsDNA antibodies are elevated. Chest radiography shows no pulmonary infiltrates. Which of the following is the most likely diagnosis?

1. A)Acute bacterial endocarditis with Enterococcus faecalis
2. B)Libman-Sacks endocarditisGABARITO
3. C)Fungal endocarditis secondary to disseminated candidiasis
4. D)Marantic endocarditis associated with underlying malignancy
5. E)Antiphospholipid syndrome with valve thrombosis