Problem:
A 68-year-old female patient presented to the hospital with high fever, cough, and sputum for the past 2days. Past medical history, suggestive of hypertension on meds. After the initial examination, she was hospitalized with a diagnosis of pneumonia, and third generation cephalosporins were initiated. On the third day of her hospitalization, the patient developed left sided facial paralysis and weakness in the upper and lower limbs. There was an ejection systolic murmur in right second intercostal space 2cm lateral to sternum and pansystolic murmur left fifth intercostal space 5cm lateral to sternum. Patient was referred to the department of cardiology for further advice. What are the differentials? What investigations will help with the diagnosis? Explain the abnormal investigations seen in this patient? Most likely final diagnosis?