History: Diagnosed with suppurative glossitis based on oral biopsy. No evidence of fungal or autoimmune disease on biopsy. He was placed on a 7-day course of Clavamox, and his symptoms of lethargy, fever and anorexia resolved. He also had a beta hemolytic strep UTI at 4 months of age. Chemistries have been normal.  Initial CBC had an elevated WBC, but recheck CBC was WNL. 

Pathologist suggested looking for nidus of infection such as endocarditis or prostatitis.  I submitted echo images to Dr. Lamy.  There was very mild mitral regurgitation (hemodynamically insignificant) with no valvular thickening noted.  Borderline systolic function.  Otherwise normal.  Dr. Lamy thought endocarditis unlikely.  Given the borderline function, myocarditis a possibility, but also unlikely.  She suggested running a troponin level.  Unsure if this has been done yet.  The patient has no arrhythmia.  

My abdominal ultrasound was unremarkable.  Wondering additional steps you would recommend, pending follow up on the troponin.