Author: Alex Koyfman, MD (@EMHighAK) // Reviewed by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER)
Welcome back to the EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed.
This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. Please message us over Twitter and let us know if you have any feedback on ways to improve this for you. Enjoy!
Case #1:
A 42-year-old male with a history of IV drug use presents with fevers, chills, and myalgias. He was seen 2 days ago and diagnosed with an upper respiratory infection. He is febrile in the ED, and he states is symptoms have worsened with increased generalized weakness. You detect a 2/6 murmur on your exam, but his lungs and skin are otherwise normal.
Considerations:
- When should endocarditis be considered? How can it present?
- What are the risk factors on history, and what might you find on examination?
- What is the ED work-up of suspected endocarditis?
- When should these patients be given antibiotics, and when they are administered, what antibiotics are recommended?
- What are potential complications of endocarditis?
- When should you consult cardiothoracic surgery for endocarditis?
Suggested Resources:
- Articles:
- MDCalc – Duke Criteria
- emDocs – Flu mimics
- REBEL EM – Endocarditis
- emDocs – Endocarditis – a complicated case
- EMPharmMD – Antibiotics
- Podcasts:
- PMID:
