A 25-year-old man is brought to the emergency department because of a 6-day history of fever and chills. During this period, he has had generalized weakness, chest pain, and night sweats. He has a bicuspid aortic valve and recurrent migraine attacks. He has smoked one pack of cigarettes daily for 5 years. He does not drink alcohol. He has not used any illicit drugs . Current medications include propranolol and a multivitamin. He appears ill. His temperature is 39°C (102.2°F), pulse is 108/min, respirations are 14/min, and blood pressure is 150/50 mm Hg. On pulmonary examination, diffuse crackles are heard. A grade 3/6 high-pitched, early diastolic, decrescendo murmur is best heard along the left sternal border. An S3 gallop is heard. Three sets of blood cultures are sent to the laboratory and grow gram-positive cocci that synthesize dextrans from sucrose. The organism contributing to this patient's current condition is also associated with which of the following?

Question

A 25-year-old man is brought to the emergency department because of a 6-day history of fever and chills. During this period, he has had generalized weakness, chest pain, and night sweats. He has a bicuspid aortic valve and recurrent migraine attacks. He has smoked one pack of cigarettes daily for 5 years. He does not drink alcohol. He has not used any illicit drugs . Current medications include propranolol and a multivitamin. He appears ill. His temperature is 39°C (102.2°F), pulse is 108/min, respirations are 14/min, and blood pressure is 150/50 mm Hg. On pulmonary examination, diffuse crackles are heard. A grade 3/6 high-pitched, early diastolic, decrescendo murmur is best heard along the left sternal border. An S3 gallop is heard. Three sets of blood cultures are sent to the laboratory and grow gram-positive cocci that synthesize dextrans from sucrose.  The organism contributing to this patient's current condition is also associated with which of the following?

Quizplus · Accepted Answer

Eductional Objective: Viridans streptococci produce dextrans that aid them in colonizing host surfaces, such as dental enamel and heart valves.  These organisms cause subacute bacterial endocarditis, classically in patients with preexisting cardiac valvular defects after dental manipulation.

A 25-Year-Old Man Is Brought to the Emergency Department Because