A 34-year-old male intravenous drug user presented with dyspnea, pleuritic chest pain, hemoptysis, and bilateral lower extremity swelling. His initial vitals were temperature 38.8°C, heart rate 100/min, blood pressure 125/62mmHg, and SpO2 98% on room air. Physical exam was notable for splinter hemorrhages on his nailbeds, and track marks on his right wrist and arm. He had 2+ non-pitting edema of his lower extremities. Labs revealed leukocytosis (WBC 25,470) with a left shift. Blood cultures ultimately grew methicillin-sensitive Staphylococcus aureus.
