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March 17, 2026The Brazilian Journal of Infectious DiseasesOpen Access

Endocarditis Due to Abiotrophia Defectiva: Rare Case Report With Fatal Outcome

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Why the study?

Abiotrophia defectiva is a rare endocarditis pathogen accounting for only 1–2% of cases, associated with an aggressive clinical course, high complication rates, and scarce literature.

Population

One 67-year-old man with a bioprosthetic aortic valve and prosthetic-valve endocarditis due to Abiotrophia defectiva

Design

Case report

Key result

Prosthetic-valve endocarditis due to Abiotrophia defectiva in a 67-year-old man resulted in mixed shock and death despite antimicrobial therapy and urgent valve replacement.

Authors

PPPietra Giovana PoliseliGZGrazielle ZanattaLVLuísa Weffort Vicente

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Overview

Requires heightened vigilance for aggressive Abiotrophia defectiva prosthetic-valve endocarditis; extends limited data on this rare (1-2%) pathogen and MALDI-TOF utility.

Key Points

  • To report a rare case of endocarditis caused by Abiotrophia defectiva in a patient with prosthetic heart valve.
  • Reported case of a 67-year-old man with prosthetic valve endocarditis due to A. defectiva.
  • Utilized MALDI-TOF mass spectrometry for accurate microbial identification.
  • Administered antimicrobial therapy with penicillin and gentamicin, later switched to vancomycin after therapeutic failure.
  • Conducted urgent valve replacement and managed hemodialysis for renal dysfunction.
  • Patient developed severe renal dysfunction and multiple complications including coagulopathy and severe anemia.
  • Antimicrobial therapy failed to show clinical improvement, leading to urgent surgical intervention.
  • Postoperative complications included mixed shock, with ultimate fatal outcome.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P
Population
1 67-year-old man with a bioprosthetic aortic valve implanted 15 years earlier, dyslipidemia, and benign prostatic hyperplasia presenting with prosthetic-valve endocarditis due to Abiotrophia defectiva.
I
Intervention
Antimicrobial therapy (penicillin plus gentamicin, later switched to vancomycin), hemodialysis, and urgent valve replacement.
O
Outcome
Clinical outcome (survival/death)hard clinical

This case highlights the aggressive clinical course, diagnostic difficulty, and poor prognosis of prosthetic-valve endocarditis caused by the rare pathogen Abiotrophia defectiva, emphasizing the utility of MALDI-TOF for accurate identification.

Limitations

  • Diagnostic difficulty
  • Lack of standardized susceptibility testing

Cite This Study

Poliseli et al. (2026) conducted a case report in Prosthetic-valve endocarditis due to Abiotrophia defectiva (n=1). Antimicrobial therapy and urgent valve replacement was evaluated. Prosthetic-valve endocarditis due to Abiotrophia defectiva in a 67-year-old man resulted in mixed shock and death despite antimicrobial therapy and urgent valve replacement.

synapsesocial.com/papers/69b8ef6ddeb47d591b8c582fhttps://doi.org/10.1016/j.bjid.2026.105013
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