Cardiovascular system microbio Welcome to your Cardiovascular system A 9-year-old girl is brought to the emergency department due to a sudden onset of uncontrollable and continuous writhing and jerking of the arms and hands. One month ago, she had a sore throat that resolved spontaneously after a few days. During that time, she also had a low-grade fever with no chills. Physical examination shows a pericardial friction rub and subcutaneous nodules over the hands. Laboratory studies show an elevated ESR. 1. What is the most likely diagnosis? Acute rheumatic fever Scarlet fever Viral meningitis Juvenile-onset SLE Which investigation would NOT help to confirm diagnosis? antistreptolysis O (ASO) titre throat swab for streptococcus group A antideoxyribonuclease B (anti-DNase B) titre Electrocardiogram What is the causative agent? with beta hemolysis on blood agar with alpha hemolysis on blood agar with with A 28-year-old woman comes to the emergency department with fever, chills, and generalized weakness for the past week. She is an intravenous drug user. Temperature is 40 C, blood pressure is 110/65 mmHg, pulse is 110/min, and respirations are 24/min. Examination shows a normal oropharynx, and lungs are clear to auscultation. A holosystolic murmur is heard at the lower sternum which increases in intensity with inspiration. What is the most likely diagnosis? Infective endocarditis Acute rheumatic fever Gram negative septicemia Meningococcemia What is the most likely causative agent? A 55-year-old woman comes to the emergency department due to a 3-week history of fatigue and exertional shortness of breath. The patient had rheumatic fever as a child and was diagnosed with mild mitral stenosis as an adult. She has progressive dental caries requiring several tooth extractions; the last was 4 weeks ago. Temperature is 37.8 C, blood pressure is 120/70 mmHg, and pulse is 92/min and regular. Cardiac examination shows a 3/6 holosystolic murmur at the apex as well as a diastolic rumble. A linear hemorrhage is present under the right index nail. What is the most likely diagnosis? Sub-acute infective endocarditis Rheumatic fever Libman-Sacks endocarditis Non-bacterial thrombotic endocarditis What is the most likely causative organism A 34-year-old man is evaluated for malaise and palpitations over the last 4 weeks. He also reports low-grade fever. He denies any sick contacts or recent travel. The patient has a history of type 1 diabetes mellitus. A 2/6 holosystolic murmur is heard at the apex. Echocardiography shows a 5-mm mobile mass attached to the anterior leaflet of the mitral valve and mild to moderate mitral regurgitation. All four of the blood cultures are negative in 48 hours. What is the most likely diagnosis? Acute infective endocarditis Subacute infective endocarditis IVDU associated infective endocarditis prosthetic valve infective endocarditis What are the most likely causative agents? Candida spp. HACEK group Staphylococcus aureus Streptococcus viridans 3. After two weeks of aerobic culture, three blood sample yielded positive in the same organism. The gram stain from colony of this organism showed below. Which genus can be this bacterium? 1. Haemophilus spp. 2. Aggregatibacter spp. 3. Cardiobacterium spp. 4. Eikenella spp. 5. Kingella spp. a. 1, 2, 3, 4, 5 b. 1, 2 c. 1, 2, 3 d. 3, 4, 5 e. 4, 5 1,2,3,4,5 1,2 1,2,3 3,4,5 4,5