Abiotrophia defectivus infectious endocarditis: think beyond the heart

Based on the Duke criteria, incorporating the echocardiographic and blood culture results, we diagnosed A defectivus endocarditis and changed the antibiotics to intravenous amoxicillin 2 g 4 hourly and gentamicin 80 mg twice daily, according to hospital protocol. Because of severe aortic regurgitation, the patient underwent an urgent tissue aortic valve replacement and mitral valve repair. The most common complications are heart failure, sepsis, and embolic events.1 More rarely it is associated with rheumatological signs, haemophagocytic syndrome, and mycotic aneurysms.3-5 Surgery is usually needed, but low susceptibility to antibiotics and late diagnosis often result in treatment failure.3A defectivus endocarditis has an indolent course, which contributes to its late detection and high mortality and complication rates.