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The lecture Cardiac Case: 22-year-old Woman with Fever and Ankle Edema after Long-term Heroin Abuse by Joseph Alpert, MD is from the course Cardiovascular Cases.
A 22-year-old woman with a long history of intravenous heroin use presents to the hospital with fever, loss of appetite, weight loss, and peripheral ankle edema. On physical examination, she appears chronically ill and cachectic. Her blood pressure is 88/55 mm Hg, heart rate is 105 beats/min, and the temperature is 39.5°C. Her sclera appears slightly jaundiced, her liver is enlarged, and grade 2 peripheral edema is noted. On cardiac auscultation, a 3/6 holosystolic, blowing murmur is heard over the sternum without radiation. Laboratory studies show increased bilirubin levels. Echocardiography is performed and reveals large vegetations on the tricuspid valve. Which of the following pathogens is the most likely cause of this patient's condition?
A 22-year-old woman with a long history of intravenous heroin use presents to the hospital with fever, loss of appetite, weight loss, and peripheral ankle edema. She is admitted. On physical examination, she appears chronically ill and cachectic. Her blood pressure is 88/55 mm Hg, heart rate is 105 beats/min, and the temperature is 39.5°C. Her sclera appears slightly jaundiced, her liver is enlarged, and grade 2 peripheral edema is noted. On cardiac auscultation, a 3/6 holosystolic, blowing murmur is heard over the sternum without radiation. Laboratory studies show increased bilirubin levels. Blood culture results show growth of methicillin-resistant Staphylococcus aureus, and an echocardiogram reveals large vegetations on the tricuspid valve. Which of the following is the most appropriate antibiotic choice for this patient?
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