2nd May 2024

A 63-year-old woman with a history of mitral valve prolapse presents to the emergency department with a 3-week history of intermittent fever, fatigue, and a new heart murmur.

A 63-year-old woman with a history of mitral valve prolapse presents to the emergency department with a 3-week history of intermittent fever, fatigue, and a new heart murmur. Blood cultures are positive for penicillin-susceptible Streptococcus bovis. An echocardiogram reveals vegetations on the mitral valve with moderate regurgitation, but no signs of heart failure. Her renal function is normal. What is the most appropriate initial management for this patient?