Section: USMLE

22) A 37-year-old woman presents to the emergency department with a fever. Chest x-ray film shows multiple patchy infiltrates in both lungs. Echocardiography and blood cultures suggest a diagnosis of acute bacterial endocarditis limited to the tricuspid valve. Which of the following is the most probable etiology?

1. Congenital heart disease
2. Illicit drug use
3. Rheumatic fever
4. Rheumatoid arthritis
5. Systemic lupus erythematosus