A 76 year old male with a past medical history of ischemic cardiomyopathy, DM2, HLD, HTN, COPD comes to clinic with a chief complaint of fevers. He denies any other symptoms On physical exam you hear a systolic ejection murmur grade I that has been present for years. He has a fever of 100.9 but all other labwork is negative. Blood cultures are positive for two out of two staphylococcus epidermidis. TEE is obtained which is negative for vegetations. You start him on linezolid for 2 weeks for bacteremia.
Three days later the patient calls and reports persistent fevers — he now is slightly short of breath more than usual but he also went to Denny’s every day this past weekend and Long John’s Texas Steakhouse. He is usually well controlled.