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23 Oct 2016 - General

A young gentleman, with background history of asthma, alcohol escess, an active intravenous drug users, with poor social situation, was admitted through casualty due to few days history of intermittent fever and rigors, with night sweats, general unwell, and lethargy. On further questioning, he denied any chest pain, shortness of breath, headache, productive cough or urinary system. He did had a few episodes of rigors for the last 3 days, with fever. Temperature was 38 celcium on arrival. No signs of cellulitis, and his injection sites looked clean. On examinatiom, there was a soft systolic mumur. His CRP was around 200, with raised white cell count and neutrophi. What is your differential diagnosed ? What investigations should be done? What treatment should be offered ??

You Yi Hong as per my understanding with subject patient seems to be dtug addict and alcoholic. I am suspecting it as rheumatic fever associated with aorotic valve disease. Further given with NSAIDs Antibiotics. Investigation on heart further required with ECG/ECHO. This is my theorfitical aspect. Md Shamim Reza opinion on Infeciv...
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My diagnosis is Infective Endocarditis.
This is a case of intravenous drug user with temperature more than 38℃, raised CRP and a soft systolic murmur. All of these are within the criteria of infective endocarditis. The most probable organism is Streptococcus aureus, which have entered through injection site.
The most important investigation is blood culture and sensitivity test. It will confirm the infection and help to select the most sensitive antibiotic.
An echocardiogram will co...
 (Total 119 words)