摘要A21-year-old male farmer was admitted to our hospital on December 28,2011 with intermittent fever and chills of three months duration.Two weeks previously he had developed chest congestion and shortness of breath.His medical history was unremarkable.On physical examination,his temperature was 37.5℃,pulse 115/ min,and respiratory rate 20/min.His blood pressure was 118/49 mmHg.Cardiac auscultation revealed the presence of a systolic ejection murmur at the left sternal border and diastolic murmur at the right sternal border.A transthoracic echocardiogram performed on December 28 revealed left ventricular hypertrophy,an 8 mm ventricular septum,mild aortic valve stenosis,moderate to severe aortic insufficiency,moderate mitral valve insufficiency,vegetation on the aortic valve (measuring 5 mm×5 mm),and trace pericardial effusion.The remaining physical examination was unremarkable.The laboratory test results for this patient are shown in the Table 1.