A non-valvular infective endocarditis in an HIV patient with myocardiopathy

A 37-year-old woman presented in the emergency department revealing a history of HIV infection and C virus hepatitis diagnosed 15 years ago, acquired after a period of intravenous drug abusing. The patient was receiving triple antiHIV therapy and was in an A1 stage (last lymphocite recount of CD4: 0.63 10/l and no AIDS disease manifestation to the present moment). She described episodes, starting 20 days before, of torathic pain coexisting with shivers. There were no symptoms or signs of any focal infection. In the physical examination the only findings were a temperature of 38.4 8C, a 4 cm hepatomegaly and lipodystrophy. We found in the electrocardiogram a sinus rhythm, 96 bpm and no ST se…