🚨 IV drug user fever hemoptysis? This isn’t pneumonia. Think deeper. 👀🫀 Fever, cough, pleuritic chest pain, hemoptysis, and a holosystolic murmur louder on inspiration = 🚩 right-sided infective endocarditis until proven otherwise. Most common culprit? Staphylococcus aureus. Why the lung symptoms? Septic pulmonary emboli → pulmonary infarcts or abscesses. 📌 Workup that actually matters: • Start with TTE for suspected infective endocarditis • High suspicion negative TTE? → TEE is the move • D

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