A 31 year old man who injects heroin presents with fever, pleuritic chest pain, and shortness of breath. Examination shows a new holosystolic murmur at the left lower sternal border and several painless erythematous macules on the palms and soles. Blood cultures grow gram positive cocci in clusters. Which of the following is the most likely diagnosis?
- A)Dilated cardiomyopathy
- B)Infective endocarditisGABARITO
- C)Restrictive cardiomyopathy
- D)Aortic dissection
- E)Acute rheumatic fever
Explicação
Infective endocarditis is correct. Injection drug use predisposes to acute Staphylococcus aureus infection of the tricuspid valve, causing fever, a regurgitant murmur, and septic pulmonary emboli that produce pleuritic symptoms. The painless lesions on the pal... Ver explicação completa e trilha adaptativa →