Presentation is often nonspecific and most commonly includes fever.
Historical sources of bacteremia should be considered, such as indwelling vascular catheters, recent dental work, and intravenous drug use.
Symptoms are often subtle and exam is often unrevealing, but may demonstrate cardiac murmur, peripheral emboli, Osler nodes, Roth spots, and Janeway lesions.
Three sets of blood cultures should be obtained prior to initiation of antibiotic therapy.
An echocardiogram should be obtained in all suspected cases.
Treatment is guided by presentation, clinical findings, and organism virulence.
From the collection of Sanjay Sharma, St George's University of London, UK