Problem
A 63-year-old physician has noted increasing fatigue and malaise for the past couple of months. When she takes her temperature, she is surprised to find that it is 1006". She also notes some new lesions on her arms and nails. She is too busy to see her own physician. What finally brings her to medical attention is the development of red, painful swelling on the dorsum of her left foot. Her physician notes Roth spots in both eyes and a loud mitral insufficiency murmur. Of note, she has a longstanding history of mitral valve prolapse.
I. What is the causative agent, how does it enter the body and how does it spread a) within the body and b) from person to person?
II. What is the host response to the infection and what is the disease pathogenesis?
III. What is the typical clinical presentation and what complications can occur?
IV. How is this disease diagnosed and what is the differential diagnosis?
V. How is the disease treated and/or prevented?