Background: Echocardiography is an essential evaluation in the diagnosis of infectious endocarditis (IE). Transthoracic echocardiography (TTE) is a portable study that is widely available and non-invasive. Though transesophageal echocardiography (TEE) is traditionally known for higher sensitivity and specificity, it is speculated that improvements in modern TTE imaging could produce higher diagnostic yield than previously thought. [...]

Case Presentation: A 54 year-old-woman presented with one week of progressive fatigue, shortness of breath, and productive cough.  Physical exam revealed fever of 101.6⁰ F, poor oral dentition, bilateral pulmonary crackles and left lower quadrant abdominal tenderness. Initial laboratory workup was remarkable for elevated procalcitonin which prompted initiation of broad spectrum antibiotics. Chest X-ray was [...]

Case Presentation: A 59-year-old male with a bicuspid aortic valve presented to the hospital with a syncopal event. One week earlier, a transesophageal echocardiogram (TEE) done for preoperative assessment had confirmed a heavily calcified bicuspid aortic valve and severe aortic insufficiency. He also reported 2 months of night sweats without fevers, 25-pound weight loss, and [...]

Case Presentation: A 57-year-old female with a medical history of uncontrolled diabetes with a hemoglobin A1C of 14, hypertension, and a previous right-sided stroke presented to the emergency department with a four-day history of nausea, vomiting, watery diarrhea, fever and chills. On presentation, the patient was hemodynamic stable with no fevers. Physical examination revealed no [...]

Case Presentation: A 36-year-old male with a medical history significant for IV heroin abuse and bipolar disorder presented to the hospital with confusion, fever and chills. Initial vitals were concerning for septic shock, and the patient was promptly started on broad-spectrum antibiotics and aggressively fluid resuscitated following sepsis protocols. Physical examination was concerning for a [...]

Case Presentation: 27 year old Caucasian female admitted with fever, abdominal pain radiating to back. She was not an IV drug user. Has a recent history of facial abscess following spider bite but no signs of cellulitis over extremities. There was a small red spot on lower right eyelid, no Osler nodes, janeway lesions, no [...]

Case Presentation: An 82-year-old man with a history of hypertension and known aortic insufficiency presented with bilateral lower extremity rash, ankle edema, and bradycardia. The ankle edema began two weeks prior to presentation followed by an erythematous, pruritic rash on his anterior shins. He initially presented to urgent care and was found to have a [...]

Case Presentation: A 30 year old man with a history of type 1 diabetes mellitus and bioprosthetic aortic valve replacement (AVR) for endocarditis presented with 2 days of left eye pain and vision loss associated with fevers, headache, and nausea. He reported intravenous drug use (IVDU) 4 days prior to admission after 14 months of [...]

Case Presentation: A 93-year-old African-American male with history of CVA, HTN, and dementia presented with a right femoral neck fracture after a same level fall. Vital signs on admission were unremarkable. Physical examination revealed a cachectic male at his baseline mental status. He was admitted and underwent uncomplicated right hemiarthroplasty. On post-operative days 3-5, patient [...]

Case Presentation: A 29-year-old man with medical history of type 1 diabetes mellites complicated by chronic nonhealing diabetic foot wound presented with one week history of shortness of breath and malaise. On physical exam he was hemodynamically stable and had a new grade II/VI holosystolic murmur at lower sternal border. Initial laboratory workup revealed elevated [...]