A 71-year-old man presents with fever (38.9°C), malaise, and a new cardiac murmur. Vital signs show BP 128/76, HR 104, RR 18, SpO2 98% on room air. Blood cultures grow group D, gamma-hemolytic gram-positive cocci that do not grow in 6.5% NaCl. Transoesophageal echocardiography reveals 8-mm vegetations on the aortic valve. He denies recent dental procedures. Which additional evaluation is most appropriate?
- A)HIV viral load measurement
- B)MRI of the brain for temporal lobe lesions
- C)CT scan of the chest to assess for cavitary lesions
- D)ColonoscopyGABARITO
- E)Serum cryoglobulin testing
Explicação
Colonoscopy is correct. Streptococcus gallolyticus, formerly S bovis, bacteremia or endocarditis is strongly associated with colonic adenomas and adenocarcinoma, so colon evaluation is required. The group D nonenterococcal profile supports this organism. Ver explicação completa e trilha adaptativa →