A 51-year-old man was admitted with presumed sepsis with the following history. He had a history of intravenous drug use. He had fever and malaise for two weeks prior to admission. The patient was alert and oriented and his physical examination was unrevealing. BP 78/35; HR: 140; RR 32; and temperature of 104.3º F. The patient received piperacillin-tazobactam, gentamicin, and vancomycin pending culture results.
A CXR taken on admission showed a complete absence of pulmonary edema. About six hours later, the patient developed acute respiratory failure requiring intubation. A CXR was taken to assess ET (endotracheal tube) positioning showed asymmetric infiltrates affecting the right lung field. A TTE (transthoracic echocardiogram) performed a few hours after intubation revealed severe acute mitral regurgitation with anterior leaflet tear. *This case is from Docplexus editorial team for…
