Abiotrophia defectiva: A Rare Causative Agent of Infective Endocarditis With Severe Complications

Abstract

Infective endocarditis (IE) primarily affects the endocardium of the heart valves. One of the common neurological complications of IE is the embolization of endocardial vegetation, which can obstruct the cerebral arteries. We describe the case of a 47-year-old male patient who developed neurological symptoms as a complication of IE. Abiotrophia defectiva, a nutritionally altered Streptococcus, was identified in his blood culture. Treatment of both neurological and vegetative complications is often challenging and necessitates the involvement of a multidisciplinary team. Given the high mortality rate associated with these complications, the diagnosis of IE should be taken into consideration for individuals presenting with fever and neurological abnormalities.

Keywords: abiotrophia defectiva; embolization; infective endocarditis; rheumatic heart disease; stroke.

Figure 1. CT of the brain

(A) The red arrow highlights the intraparenchymal hemorrhage in the right basifrontal lobe with surrounding edema. (B) The red arrow highlights the hemorrhagic focus in the posterior limb of the left internal capsule. (C) The red arrow highlights a subacute to chronic nonhemorrhagic infarct in the right corona radiata. CT: computed tomography.

Figure 2. 2D echocardiogram image

The white arrow highlights the vegetation on the aortic valve.