A 35-year-old man presented with a 3-week history of fever, night-sweat, chills, and weakness. He was a blacksmith by profession. He had no other symptoms and did not have any significant medical history except getting dental implants 6-months ago. He denied smoking, drinking or taking any illegal drugs.
He lived in a village farm which had livestock like cattle, chicken, rabbit, and lambs. He had visited his family physician ten days before presentation and he was prescribed levofloxacin (500 mg/d per os). Physical Examination: Blood pressure: 150/76 mmHg Atmospheric air oxygen saturation: 99%, Heart rate: 93 beats/min Good level of consciousness Diastolic murmur in second right intercostal space (aortic valve area) No mucocutaneous sign of endocarditis Laboratory tests CRP: 2.5 mg/dl ESR: 20 mm/h WBC count: 12.000/μL Urine analysis: normal Urine culture: normal Ultrasound of…
