A Native Valve Endocarditis with Abiotrophia defective - An Emerging Pathogen of Concern

Abiotrophia defectiva has emerged as a recognized cause of culture negative endocarditis. It poses significant diagnostic and therapeutic challenges. Patients with Abiotrophia defectiva endocarditis are at significant risk for developing severe valve damage and experiencing relapse after completion of treatment. We present a case of microbiologically confirmed Abiotrophia endocarditis in a patient with no comorbidity and no underlying cardiac disease. The patient had progressive dyspnoea and orthopnoea for which he was evaluated. ECG findings were suggestive of left ventricular hypertrophy and echocardiogram revealed aortic and mitral valve destruction with vegetations over anterior mitral leaflet. Abiotrophia defectiva was isolated from 3sets of blood culture and the patient was treated with Ceftriaxone and gentamicin. Repeat blood cultures were negative and ceftriaxone was continued for 6weeks to prevent relapse. Valve replacement was planned after the complete course of antibiotics. In summary, the increasing incidence of Abiotrophia defectiva endocarditis is accompanied by disturbingly high rates of relapse, valve destruction, and embolic complications, underscoring the urgent need for prompt diagnosis and aggressive management to prevent devastating outcomes.

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