Staphylococcus aureus endocarditis in a previously healthy adolescent

Infectious endocarditis is occasionally a complication of Staphylococcus aureus sepsis in previously well individuals with no heart disease or history of intravenous drug use. We report a case of a 16 year old who developed Staphylococcal sepsis and endocarditis probably as the result of neglected paronychia of her toes. Despite adequate antibiotic therapy, the infectious process destroyed her aortic valve, thereby producing aortic regurgitation complicated by cerebral embolism. Aortic valve replacement surgery was required. Endocarditis should always be sought with S. aureus bacteremia. Intravenous high-dose antibiotic therapy for at least 4 weeks is the recommended therapy.