Description

A man aged 27 years from Bangladesh was referred to our centre for evaluation of fever of unknown origin of 3 months duration. There was a history of progressively increasing dyspnoea of NYHA functional class II for 25 days. He had received antibiotic therapy for a week prior to his presentation to us. Physical examination revealed muffled first heart sound with loud pulmonary component of second heart sound. A grade IV/VI (Levine grade) pan systolic murmur was heard over the apex, radiating to the left axillae. There were no clinical stigmata …