此例患者急性心肌梗死溶栓术后，术后间断发热。超声显示二尖瓣前叶赘生物（6 mm）形成。考虑左心感染性心内膜炎，给予万古霉素联合哌拉西林/他唑巴坦治疗10 d后，出现急性肾功能损伤。遂调整方案为达托霉素［剂量选择8 mg/（kg?d）］，血肌酐持续高，故调整为8 mg/（kg?q48 h），进一步调整为6 mg/（kg?q48 h）。在6周的达托霉素治疗过程中，患者未再有发热，红细胞沉降率（ESR）下降，肾功能逐渐正常，同时心脏彩超显示赘生物进一步减小，显示治疗有效。

This patient had intermittent fever with acute myocardial infarction after thrombolytic therapy. The ultrasound showed the formation of mitral valve anterior excrescence (6 mm) . Acute kidney injury occurred 10 days after the treatment of Vancomycin combined with Piperacillin / Tazobactam for the consideration of the left-sided infective endocarditis. In the beginning, our adjustment program was the treatment of Daptomycin [dose 8 mg / (kg?d)] , but serum creatinine (Scr) continued to rise, so we adjusted the dose of 8 mg / kg?q48 h, further adjusted the dose of 6 mg / kg?q48 h. Dring the treatment with Daptomycin of 6 weeks, no further fever in patient and the erythrocyte sedimentation rate (ESR) decreased, the kidney function gradually turned to normal while the echocardiography showed the excrescence further reduced , this treatment was effective.