感染性心內膜炎(Infective Endocarditis, IE)是心臟內膜受微生物感染所引起的嚴重疾病，其診斷挑戰主要來自於非特異性症狀和多樣化臨床表現，臨床醫師在面對高風險族群、且同時有發燒情況時應特別納入考量。此篇病例報告呈現一位具心衰竭病史、主動脈瓣中度閉鎖不全、近期置入洗腎導管行血液透析的個案，最終確診為感染性心內膜炎、接受主動脈瓣置換手術。藉此個案回顧感染性心內膜炎的臨床症狀和2023年更新的診斷標準，早期鑑別並適時處置，提升疾病預後; 也因應基層醫師職責針對高風險族群進行預防建議，降低感染風險。

Infective endocarditis (IE) is a severe condition caused by microbial infection of the heart’s endocardium. Diagnostic challenges arise primarily from nonspecific symptoms and variable clinical presentations. Clinicians should remain particularly vigilant when managing high-risk patients presenting fever. This report describes a patient with a history of heart failure, moderate aortic valve regurgitation, and a recent dialysis catheter placement for hemodialysis, who was ultimately diagnosed with IE and underwent aortic valve replacement surgery. Through this case, we review the clinical symptoms of IE and the updated 2023 Duke-International Society for Cardiovascular Infectious Diseases criteria, emphasizing the importance of early recognition and timely intervention to improve patient outcomes. We also offer recommendations for primary care physicians to help prevent infections in high-risk populations and reduce the incidence of IE.