A parent of a 7-year-old girl with a repaired ventricular septal defect (VSD) calls the cardiology clinic and reports that the child is just not herself. Her appetite is decreased, she has had intermittent fevers around 38° C (100.4° F), and now her muscl
a. Immediately bring the child to the clinic for evaluation.
b. Come to the clinic next week on a scheduled appointment.
c. Treat the signs and symptoms with acetaminophen and fluids because it is most likely a viral illness.
d. Recognize that the child is trying to manipulate the parent by complaining of vague symptoms.
ANS: A
These are the insidious symptoms of bacterial endocarditis. Because the child is in a high-risk group for this disorder (VSD repair), immediate evaluation and treatment are indicated to prevent cardiac damage. With appropriate antibiotic therapy, bacterial endocarditis is successfully treated in approximately 80% of the cases. The child's complaints should not be dismissed. The low-grade fever is not a symptom that the child can fabricate.
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