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Endocarditis with embolic stroke — ABEM Board MCQ

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ModerateCardiovascular emergenciesEndocarditis with embolic strokeABEM Board

A 41-year-old man who injects drugs arrives with fever and right arm weakness. Triage acuity is ESI 2; T 102.4 F, BP 118/70 mm Hg, HR 116/min. He has a new holosystolic murmur and petechiae on the conjunctivae. CT head shows no hemorrhage. Which of the following is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Infective endocarditis with embolic ischemic stroke

Fever, injection drug use, new murmur, peripheral stigmata, and focal neurologic deficit suggest endocarditis complicated by embolic stroke.

Reference: AHA infective endocarditis guidance; ACEP stroke policy