Naďa Hučková, Marián Kozlovský, Vasiľ Hricák
Issue background: Infective endocarditis (IE) belongs to diseases with no significant decrease of its incidence and mortality despite current trends and effort. IE can be characterized as an inscrutable disease with a variable initial clinical picture which depends on the actual microbe, presence of possible complications and general physician´s abilities. Therefore the entire issue deserves complex approach including a cardiologist, first contact physician, surgeon, infectologist, neurologist and other relevant specialists. Case Report: Our case reports a 55-year old male subject without any previous cardiac disease, three months lasting intermittent febrility within suspect borreliosis. Subject was repeatedly treated with azithromycin within out-patient care. Regarding the physical conditions upon the first visit, our subject was dyspnoeic and unable to walk, with presence of anasarca, and complained about lack of appetite and loss of weight. Laboratory parameters showed anaemia. Echocardiography proved presence of vegetations and destroyed aortal valve, therefore we were able to set up the diagnosis of IE upon medical history, clinical signs and upon echocardiography. Subject refused hospitalization. Therefore we were forced to provide onset of peroral antibiotic therapy with two ATBs and complex treatment of heart failure. After six weeks the inflammation was reduced and fever disappeared however the heart failure (left and right heart failure) continued. The complex pharmacological treatment and cardiosurgery replacement of aortal valve and implantation of permanent defibrillator provide the subject almost full-value life.