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 BOF 115

 

   

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BOF: 115

A 68 year old patient presents with a history of fever. Apart from a cystoscopy a few weeks prior to presentation he had been previously fit and well.  He was not on any medication.

On examination he was febrile, there were splinter haemorrhages in his finger nails and there was clubbing. The pulse rate was 100 beats per minute and he had a bisferiens pulse. JVP was not elevated, apex was not displaced, the second heart sound was soft, there was an ejection systolic murmur radiating into his neck and he had an early diastolic murmur at the left sternal edge. He had splenomegaly. Multiple blood cultures are taken from this patient.

Which one of the following organisms is likely to be isolated?

a)      Staphylococcus aureus

b)      Streptococcus viridans

c)      Proteus mirabilis

d)     Bartonella species

e)      Coxiella burnetii

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