A Febrile, Hypotensive Patient With Bilateral Lung Crackles

A 61-year-old man with 1 day of dyspnea and weakness was febrile (38.4 °C), hypotensive, tachycardic, diaphoretic, and had poor dentition, a soft S1, and basilar bilateral crackles on examination and aortic regurgitation on transesophageal echocardiography. What is the diagnosis and what would you do next?
Source: JAMA - Journal of the American Medical Association - Category: General Medicine Source Type: research