A 32-Year-Old Man Is Brought to the Emergency Department with a Several-Day

A 32-year-old man is brought to the emergency department with a several-day history of high-grade fever, dyspnea, and fatigue.  The patient's temperature is 39.4 C (102.9 F) , blood pressure is 122/70 mm Hg, and pulse is 102/min and regular.  Physical examination reveals a new holosystolic murmur with a blowing quality that is best heard over the cardiac apex.  Skin examination shows nontender lesions on the sole of the feet, as shown in the image below. Which of the following do these lesions most likely represent?

A) Areas of local vascular growth
B) Foci of granulomatous inflammation
C) Immune complex-mediated vascular lesions
D) Microemboli to skin vessels
E) Primary infection foci

Correct Answer:

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