Extensive Dental Caries

A 48 year old man presented with fever. Blood cultures were positive for streptococcus. An echocardiogram revealed a vegetation on mitral valve. Source of initial infection was not clear. He was noted to have poor oral hygiene.
Panorex was ordered which is shown below

Panorex showing Extensive Dental Caries

Panorex showed dental caries as shown by the arrows.

It was concluded that the most likely source of introduction of streptococcus infection is his mouth.

Follow up with his dentist was recommended post discharge.