{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:37:55Z","timestamp":1786649875561,"version":"build-2736575974"},"reference-count":4,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>A 17-year-old previously healthy girl presented with 7 days of fever and classical peripheral findings including Osler\u2019s nodes, Janeway lesions, splinter hemorrhages, and Roth\u2019s spots. Echocardiography revealed a large vegetation attached to the posterior mitral leaflet. Blood culture later grew methicillin-sensitive Staphylococcus aureus. Despite antibiotic therapy, the vegetation increased in size with splenic embolization, requiring urgent mitral valve replacement. 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