Table 1.

Timeline with the main clinical events and interventions

Time	Day 0	Day 4	Day 10	Day 15	Day 23	Day 32
Events	• Hospitalization • Mitral endocarditis diagnosis • Acute left tibial artery occlusion	• Septic shock • Sustained fever • Severe mitral regurgitation	• Daily fever • Splenic abscess diagnosis	• Recurrent fever • Persistence of splenic abscess	• Distal left lower limb gangrene	• Clinical recovery
Interventions	• Orotracheal intubation and mechanical ventilation • Antimicrobial therapy • Vascular thrombectomy	• Mitral valve replacement surgery	• Percutaneous splenic drainage	• Surgical splenectomy	• Left forefoot amputation	• Hospital discharge