A 22-Year-Old Woman with Headache, Fever, and Respiratory Failure

   This case details a 22-year-old woman transferred for acute headache, fever, respiratory failure, and multiorgan findings. Initial symptoms included nausea, myalgias, photophobia, and confusion. Imaging revealed subarachnoid hemorrhage, cortical infarcts, pulmonary nodules, and splenic hypodensities. Lumbar puncture confirmed meningitis; blood cultures identified Haemophilus parainfluenzae. Echocardiography demonstrated mitral-valve vegetations and perforations, confirming infective endocarditis with septic emboli. Neuroimaging showed multifocal subarachnoid hemorrhage and infarcts. Valve surgery repaired leaflet damage; pathology confirmed dense neutrophilic inflammation and fibrinoid necrosis. The patient completed six weeks of intravenous ceftriaxone and recovered fully.

   This case details a 22-year-old woman transferred for acute headache, fever, respiratory failure, and multiorgan findings. Initial symptoms included nausea, myalgias, photophobia, and confusion. Imaging revealed subarachnoid hemorrhage, cortical infarcts, pulmonary nodules, and splenic hypodensities. Lumbar puncture confirmed meningitis; blood cultures identified Haemophilus parainfluenzae. Echocardiography demonstrated mitral-valve vegetations and perforations, confirming infective endocarditis with septic emboli. Neuroimaging showed multifocal subarachnoid hemorrhage and infarcts. Valve surgery repaired leaflet damage; pathology confirmed dense neutrophilic inflammation and fibrinoid necrosis. The patient completed six weeks of intravenous ceftriaxone and recovered fully.