Management
The patient was empirically treated initially with Piperacillin Tazobactam and Vancomycin which was subsequently changed to Ampicillin-Sulbactam and Ceftriaxone after the TTE results. She was given aspirin and colchicine for pericarditis.
The patient continued to have episodes of shortness of breath accompanied by reduction in oxygen saturation which improved with supplemental oxygen. CT angiogram of the Chest excluded the possibility of septic pulmonary embolism. However patchy ground glass infiltrates consistent for viral pneumonia and right middle lobe consolidation was present. She was treated for hospital acquired pneumonia with subsequent resolution of symptoms. A peripherally inserted central catheter (PICC) line was placed and patient was transferred to a subacute rehabilitation center for completion of antibiotics. She responded well to the course of antibiotics with plan for repeat echo on follow up.