مريض يتعاطى المخدرات بالحقن، حرارته ٣٩، وعنده نفخة جديدة، ونقاط نزفية تحت الأظافر، وعقد مؤلمة في أطراف الأصابع. ما أول ما يتوقعه الممرض قبل بدء المضاد الحيوي؟

A client who injects drugs has a temperature of 39 °C, a new murmur, splinter haemorrhages and tender nodules on his fingertips. What does the nurse expect first, before antibiotics start?

1. A head CT before any procedure
2. Three sets of blood cultures from separate sites
3. An antipyretic and waiting for the fever to settle
4. Liver function tests to choose the antibiotic

Answer: B) Three sets of blood cultures from separate sites. This picture suggests infective endocarditis. Multiple blood cultures before antibiotics are essential to identify the organism. IV antibiotics then start promptly and run for weeks.