An aortic root abscess complicating a non-previous underlying heart disease infective endocarditis in an immunocompetent young patient: A case report

and importance: Aortic infective endocarditis is a well described fatal disease that develops along the edges of the heart valves, although it can affect native and prosthetic valves, infection seldom affects a previously normal ones. Aortic root abscess as a complication of normal native aortic valve endocarditis is less recognized and described, it is a potentially fatal condition, which the diagnosis is based on clinical, biology, echocardiography and especially the intraoperative findings. Both native and prosthetic valve infection can be complicated by an aortic abscess, associated with a significant mortality rate, which often requires surgical intervention We report here a case of young man, with no major pathological history, non-systemic or valvular predisposing diseases, was admitted for the assessment of a prolonged fever with no obvious cause, and in whom an aortic abscess was suspected on an echocardiography and confirmed by transesophageal echocardiography and histopathology, complicating a negative blood culture infective endocarditis. Up to date, the incidence of infective endocarditis continues to rise, with a significant rate of mortality and complications, however the physiopathology mechanism remain insufficiently studied. •The echocardiographic features play an important role in the diagnosis of aortic abscess, as well as the management of this serious condition.•Aortic root abscess complicating a normal native aortic valve endocarditis is rare and not well described.•The effective approach for patients with IE periannular extension involves a multidisciplinary approach, with surgical treatment playing a major role.