Start a broad-spectrum antibiotic stat
Draw blood cultures and then start an antibiotic
Draw blood cultures and do an ECHO, then start empirical antibiotics
Start prednisolone, high dose aspirin, and benzathine penicillin
Ans. C. Draw blood cultures and do an ECHO, then start empirical antibiotics
Explanation: The above clinical vignette includes a prolonged high-grade fever, murmur and splinter hemorrhages with a background of ADHD (increased incidence of drug abuse), indicating underlying infective endocarditis.DUKE’s criteria are used to diagnose IE, in which blood cultures were drawn 12 hours apart and an ECHO findings s/o IE are included as major criteria. So in any suspected case of IE, ECHO and blood cultures are done as a priority before starting antibiotics.