Infective Endocarditis due to Abiotrophia defectiva presenting as Ankle Cellulitis

Abstract

We report a case of infective endocarditis (IE) caused by Abiotrophia defectiva in an 8 year-old boy presented initially with left ankle cellulitis and fever. Blood culture showed Gram variable cocci which confirmed by Matrix-Assisted Laser Desorption Ionization Time Of Flight Mass Spectrophotometer (MALDI-TOF MS) as Abiotrophia defectiva. Vegetation seen at Mitral valve by transthoracic echocardiogram (TTE). He was diagnosed as Infective Endocarditis caused by Abiotrophia defectiva and was treated with intravenous gentamicin (6mg/kg/day) and ceftriaxone (100mg/kg/day) for six weeks. The patient had excellent outcome, vegetation was absent on repeated Echocardiography (ECHO), and the result showed no relapse after follow up. Abiotrophia defectiva should be considered as a cause of IE in patients with positive blood culture especially those caused by gram variable cocci.