FCP(SA) Part II Practice Questions - Fellowship Of The College Of Physicians Of South Africa Part II Exam

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A 45-year-old male with a mechanical aortic valve presents with fever, new heart failure symptoms, and blood cultures positive for Staphylococcus aureus. Transesophageal echocardiography reveals a 14 mm mobile vegetation on the prosthetic valve with a perivalvular abscess and a new second-degree AV block. Which of the following is the most urgent intervention?

Initiate intravenous vancomycin, gentamicin, and rifampicin and observe for 4 weeks Perform urgent temporary transvenous pacing followed by outpatient oral antibiotic therapy Increase intravenous antibiotic dosing and repeat echocardiography in 14 days Initiate targeted intravenous antibiotics and refer for emergency cardiac surgery

Correct Answer:

Initiate targeted intravenous antibiotics and refer for emergency cardiac surgery

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