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Reply To: Another interesting case

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Emma Holt

This sounds like a fun medicine case 🙂

Is the murmur new or had it previously been noted?

Looking at the images, I think that the left atrium looks subjectively enlarged, with a thickened mitral valve leaflet and some prolapse of the valve. Could this be a vegetative bacterial endocarditis lesion?

For further investigations I would want a blood culture, urine culture and I would want to examine the lame leg to look for a wound/source that could cause a blood borne infection (if anything was found then I would sample/culture if possible). After this I would be looking at imaging abdo ultrasound and CT looking for any other lesions (primary or secondary).