A 30 year old intravenous drug abuser presented with high fever, chest pain, malaise and pedal edema. He also had hemorrhagic spots under his nails.
What is your provisional diagnosis?
Infective endocarditis. Rheumatic fever is more commonly a result of strep pyogenes infection which initially manifests as a throat infection. Likely causative microorganisms include S.aureus and Strep. Viridans