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Cardiovascular and Lymphatic Diseases, Respiratory Diseases Case 1 A 24-year-old woman has been using heroin intravenously for several years.
Cardiovascular and Lymphatic Diseases, Respiratory Diseases
Case 1
A 24-year-old woman has been using heroin intravenously for several years. She felt well until about 3 weeks before her admission to the hospital. She first noticed she was running a fever, but decided to ignore it. She became increasingly weak, tired and pale. Then she noticed red spots, some slightly raised, on her palms and soles. Numerous splinterlike discolorations appeared under her fingernails. She began to cough and breathing became difficult. When she became so weak she could hardly walk, her friends insisted she go to the emergency room.
The attending physician is concerned when he learns of her intravenous drug abuse and continuing fever. She does not have a history of heart disease. She has a temperature of 102°F, is very pale, and has discoloration on her palms, soles, and under her fingernails. Most worrisome is the detection of a significant heart murmur suggesting damaged heart valves. She is showing signs of heart failure, and is admitted to the hospital.
The physician draws several samples of blood for culture and orders an echocardiogram. The echocardiogram shows what looks like abnormal growths on her heart valves.
The Gram stain result is shown below as well as the growth of the culture on blood agar.
A tube coagulase test reveals results resembling the top tube in this picture.
- What is the name of the condition this patient has?
- How did she acquire it?
- What is the most likely causative organism based on the test results above?
- What are the growths that appeared in the echocardiogram?
- What is the treatment for this disease?
