Case 2 Infectious Disease

Fever

Work it one clue at a time. The diagnosis stays hidden until you reveal it.

Clue 1

A young man is admitted to the hospital with malaise and fever. You examine his hands and find these tender nodules.

Clue 2

This should generate a hypothesis.

With your hypothesis in mind, you listen to the patient’s heart. You anticipate what you might hear. “The ears can’t hear what the mind doesn’t know.”

An additional diagnosis has now been made.

Based on the holosystolic murmur at the apex that you anticipated you would hear, you diagnose the patient with mitral valve endocarditis. Two days later, his heart sounds change. Take a listen.

Reveal next