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A 49-year-old heterosexual man was admitted after three episodes of loss of consciousness. He had received a diagnosis of HIV infection in 2002 and was virologically suppressed on Biktarvy (CD4 count 499/mm3, nadir 302/mm3). Medical history comprised Staphylococcus aureus endocarditis and mitral valve replacement in 2011, followed by daily warfarin. The same year, he was diagnosed with bacterial meningitis secondary to acute otitis. No history of intravenous drug use was known.
On admission, he reported night …
Handling editor Anna Maria Geretti
Contributors OC supported the patient and participated in the conception of this work and in the final approval of the version to be published. J-MT and LC supported the patient and participated in the final approval of the version to be published. AR did echocardiography and participated in the cardiological care and in the final approval of the version to be published.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.