The first sign was not a fever. It was bleeding in the brain.
A 5-year-old girl with a surgically repaired heart defect arrived at the hospital with a ruptured aneurysm in a branch of her left middle cerebral artery, bleeding into the frontal lobe. An echocardiogram found a growth on her mitral valve, the kind of finding that points strongly toward infective endocarditis, an infection of the heart's inner lining.
