Identifying Infective Endocarditis: Clinical Presentation and Key Signs Case Study

A 22-year-old woman presents with fatigue, shortness of breath, and loss of appetite. Her symptoms started 2 weeks ago and have progressively worsened. She has had a fever for the past 3 days and night sweats. Her past medical history is unremarkable except for a wisdom tooth extraction approximately 2 months before she came to the clinic. On physical examination, she has a temperature of 38.6° C, heart rate of 120/min, respiratory rate of 22/min, and BP of 110/85 mm Hg. She has a 4/6 holosystolic murmur that radiates to the left axilla. Skin examination reveals scattered petechiae on her extremities.

1. What is the most likely diagnosis? Justify.

2. What are common clinical findings on physical exam that are associated with this condition?

3. What risk factors are associated with an increased incidence of this condition?

4. What are the most common pathogens associated with this condition?

5. What are the most appropriate next steps in the investigations of this patient?

6. What are the possible complications of this condition?