Case 1 :

Mr. OT is a 38 y/o man who presents to the ER with a two-week history of fevers, chills, and weight loss. He is indigent, and he has poor hygiene. He has been moving from shelter to shelter. A review of his records reveal that he was recently discharged from the hospital a little over three weeks ago. He denies any cough or chest pain, but he does note drenching night sweats.

His exam is notable for a T of 102.3, HR 110, BP 120/50, RR 20. He is cachectic. He has multiple infected teeth and a notable pocket of swelling on the right upper molar. This swelling is tender. He has no cervical lymphadenopathy. His lung exam is normal. His heart exam is notable for harsh, blowing diastolic murmur that increases upon sitting the patient forward. The remainder of his exam is unremarkable.