[Clinical Picture] Uncovering culture-negative endocarditis with miliary embolic brain abscesses

A 14-year-old girl with no previous medical history presented to the emergency department of the Children's Hospital of Illinois (Peoria, USA) with a seven-day history of high-grade fevers, fatigue, abdominal and back pain, and headaches, preceded by several months of nonspecific fatigue. She had body aches, bilateral neck pain without nuchal rigidity, photophobia, abdominal tenderness, myalgias, and cervical lymphadenopathy. Her cardiac examination was typical and an infectious workup was negative, including blood cultures, comprehensive serologies for toxoplasmosis, histoplasmosis, tuberculosis, bartonellosis, cysticercosis, tick-borne illnesses, fungal, viral, and parasitic infections.