• Victoria Birlutiu and Rares Mircea Birlutiu.
• aFaculty of Medicine, Lucian Blaga University of Sibiu, Sibiu bAcademic Emergency Hospital Sibiu-Infectious Diseases Clinic cSpitalul Clinic de Ortopedie-Traumatologie si TBC osteoarticular "Foisor," Bucuresti, Romania.
• Medicine (Baltimore). 2017 Nov 1; 96 (46): e8756.

RationaleEndocarditis with Abiotrophia defectiva represents 4.3% to 6% of all streptococcal endocarditis. The article presents diagnosis issues and the complexity of the treatment.Patient ConcernsWe present the case of a female white patient, aged 26 years, who developed infectious endocarditis caused by A defectiva, in the last trimester of pregnancy, a biofilm-related infection associated with the presence of fixed braces.DiagnosesThe diagnosis of infectious endocarditis was confirmed by the cardiac ultrasound examination that revealed a voluminous vegetation on the mitral valve, and acute mitral regurgitation caused by chordae tendinae rupture, and also by isolating Abiotrophia defectiva from two positive blood cultures.InterventionsThe decision to undergo surgical intervention was taken, and a mitral valve replacement was performed. Surgical intervention that was associated with board-spectrum antibiotic therapy.OutcomesA defectiva, remains a rare cause of infective endocarditis, with a reserved prognosis that is motivated by the extensive valvular lesions and the risk of embolism.LessonsThe use of antibiotics administered in association, in the management of infective endocarditis, is mandatory.

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