Review Question - QID 213624

A 27-year-old man presents to the emergency department after he cut his hand while working on his car. The patient states a screwdriver slipped and cut his hand. The patient has a past medical history of IV drug use, malingering, multiple episodes of endocarditis requiring hospitalization, and hepatitis C. The patient does not take any medications and does not typically follow up within the healthcare system. His temperature is 98.0°F (36.7°C), blood pressure is 122/84 mmHg, pulse is 81/min, respirations are 12/min, and oxygen saturation is 98% on room air. Physical exam is notable for the finding in Figure A. The patient ends up leaving prior to his workup being completed due to the wait time. Several weeks later, the patient returns with a chief complaint of malaise. His workup is notable for a fever and a new cardiac murmur. Initial laboratory values are notable for a leukocytosis, and 2 separate blood cultures do not culture an organism in the first 4 days. Which of the following is the most likely infectious etiology of this patient’s symptoms?