Persistent Fever With Aortic Valve Endocarditis

Miguel Zabalgoitia-Reyes, MD; David J. Mehlman, MD; James V. Talano, MD
Arch Intern Med. 1985;145(2):327-328. doi:10.1001/archinte.1985.00360020169026.
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A 25-year-old woman was admitted to the hospital for suspected infective endocarditis. Nine days prior to the admission she had the onset of fever, shaking chills, diaphoresis, extreme fatigue, and anorexia. A congenital bicuspid aortic valve with mild aortic insufficiency had been documented by cardiac catheterization at 6 years of age. On admission, her abnormal physical findings were a BP of 120/40 mm Hg, a pulse rate of 92 beats per minute, and a temperature of 39.17 °C. The upstroke and volume of peripheral pulses were increased. The cardiac impulse was in the fifth left intercostal space at the midclavicular line. S1 was normal and S1 was increased in intensity. A grade 2/6 systolic ejection murmur was heard at the base. A grade 3/6 early diastolic decrescendo murmur was best heard at the fourth left lower sternal border and radiated to the apex. An ECG and a chest


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