Snapshot A 50-year-old man presents to the emergency room for prolonged fever, shortness of breath, and chest pain. He is admitted for heart failure and suspected endocarditis. A cardiac echocardiogram shows vegetation on the valves. The initial blood cultures are negative. Upon further investigation, he works at a leather supplier and often visits farms to evaluate the cattle. He is treated for a suspected zoonotic endocarditis with doxycycline and hydrochloroquine. Introduction Classification login to view 6 more bullets Prevention login to view 1 more bullet Epidemiology Incidence login to view 1 more bullet Risk factors login to view 3 more bullets ETIOLOGY Pathogenesis login to view 3 more bullets Presentation Symptoms login to view 8 more bullets Physical exam login to view 17 more bullets Imaging Chest radiography login to view 4 more bullets Echocardiography login to view 4 more bullets Studies Labs login to view 6 more bullets Making the diagnosis login to view 2 more bullets Differential Tularemia login to view 2 more bullets Bacterial endocarditis login to view 5 more bullets Treatment Medical login to view 12 more bullets Complications Adverse fetal outcomes in pregnant women Prognosis May have prolonged course if untreated Most cases resolve with treatment