Answer
Gerald's signs and symptoms ( SS) indicate a bacterial infection of the heart , specifically, the inner lining of the heart-- the endocardium. The diagnosis is endocarditis. This infection is usually caused by bacteria --streptococcus, staphylococcus or enterococcus species. Fungus infections can also cause endocarditis. Since Gerald had recently undergone dental procedures which occasioned bleeding of the gums, it is reasonable to assume that bacteria which often colonize the gums and tartar plaques on the teeth were released into his blood by the dental procedures; the pathogens then travelled to his heart and infected the endocardium.
Rapid heartbeat (tachycardia), shortness of breath (SOB), fever, sweating and chills are are all classical signs of endocarditis. Valvular murmurs would not ordinarily develop so quickly , but Gerald may have had some mild valvular insufficiency before the dental procedure, and the acute endocarditis only aggravated this condition.
Work Step by Step
Staphylococcus aureus (S. aureus) is the major cause of bacterial endocarditis. Gerald has a life-threatening condition, and it should be treated as such. The choice of antibiotic will be made after the strain of bacteria is identified. There are strains of antibiotic resistant staph bacteria. In a case like this the doctor might prescribe something like several weeks of intravenous (i.v. ) treatment with an antibiotic like vancomycin.
