Supplemental figure 2. Clinical course and antibiotics treatment. The initial potential diagnosis of this case on admission was bacterial pneumonia. Then an empiric antibacterial treatment with Meropenem (1.5 g/day) and Levofloxacin (initial 500 mg/day followed by 250 mg/day) were started. On day-2, TTE examination revealed floating mass on the surface of mitral valve and blood culture detected gram positive cocci. Levofloxacin was changed to Teicoplanin (initial 600 mg/day followed by 350 mg/day) for covering MRSA. On day-4, Streptococcus agalactiae and its antibacterial spectrum was confirmed. After the surgical removal of the vegetation and the mitral valve replacement with a bioprosthetic valve on day-5, the regimen of antibiotics was changed to Penicillin G (24 million units/day) and Gentamicin (150 mg/day). Due to drug-induced skin eruption, these drugs have been replaced to Vancomycin (2 g/day) on 5 post-operative day. Because of drug-induced kidney damage, Vancomycin has been changed to Ceftriaxone (4 g/day) on 11 post-operative day and continued thereafter until 42 post-operative day. Ab, antibiotics; CTRX, ceftriaxone; GM, gentamicin; GPC, gram-positive cocci; LVFX, levofloxacin; MEPM, meropenem; PCG, penicillin G; TEIC, teicoplanin; VCM, vancomycin (PDF 14 KB)