Family Nurse Practitioner Exam

What condition is most likely in a patient with symptoms of fever, night sweats, and red streaks on nailbeds along with a murmur?

1. Pericarditis

2. Acute bacterial endocarditis

3. Rheumatic fever

4. Viral cardiomyopathy

The correct answer is: Acute bacterial endocarditis

The presence of fever, night sweats, red streaks on nailbeds, and a murmur strongly points towards acute bacterial endocarditis. This condition is characterized by an infection of the heart valves or the inner lining of the heart caused by bacteria, and it typically manifests with systemic symptoms such as fever (due to the infectious process) and night sweats. The red streaks on the nailbeds, known as splinter hemorrhages, are a classic sign of endocarditis, indicating small emboli that occur as a result of the infection. The murmur, often caused by valve damage or infection, further supports the diagnosis. Together, these symptoms create a profile that is classic for acute bacterial endocarditis, distinguishing it from other options. Pericarditis might present with chest pain and pericardial friction rub but does not typically cause splinter hemorrhages or prominent systemic symptoms like the other condition. Rheumatic fever primarily follows streptococcal infections but would not usually present with red streaks on nailbeds. Viral cardiomyopathy can cause fever and systemic symptoms but is less likely to present with the specific combination of signs seen in this case. Thus, the symptoms align closely with acute bacterial endocard