29th July 2023

A 57 year old woman is currently an oncology inpatient, receiving chemotherapy for breast cancer treatment (1)

A 57 year old woman is currently an oncology inpatient, receiving chemotherapy for breast cancer treatment. She has been on oral fluconazole for oropharyngeal thrush. She becomes acutely unwell, spiking a high temperature and appearing drowsy. On examination, she is noted to have a systolic murmur, which is new.

Which of the following is the most important next investigation?

Select the SINGLE most appropriate option from the list below. Select ONE option only.