25 year-old male
IV drug abuse history
complaining of high fever with chills

there was intermittent spiking fevers with night sweats associated with joint pain
recently he become confused

on PE there was tachypnea and pallor with holosystolic murmur increasing with inspiration
petechiae on extremities

lab: elevated CRP , leukocytosis

what is the most likely diagnosis ?

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For those medical students

How to approch this case

Let's start together

the main points here in hte history

Age is 25 So mean young man

, Fever intermettent spiking , chills night sweat

You may think of many DDX from above data
TB ,

but with hx of IV drug you have to put question mark here So this the source of infection
and with this hx of Joint Pain you can pick up DDX
where you know the Normal flora of the skin


I tried to write simple pathway to student how do they should think