Abiotrophia defectiva triple threat: A rare case of infective spondylodiscitis, endocarditis, and brain abscess

Abiotrophia defectiva is a pathogen of the oral, gastrointestinal, and urinary tracts that can cause significant systemic disease with uniquely negative blood cultures depending on the growth medium. Prior cases note possible seeding from relatively common procedures such as routine dental work and prostate biopsies, however case literature describes prior infectious complications to include infective endocarditis, brain abscess formation, and spondylodiscitis. While prior cases describe some aspects of these presentations, we highlight a case of a 64-year-old male who presented to the emergency department (ED) f5or acute onset of low back pain with fever symptoms four days after an outpatient transrectal ultrasound-guided needle biopsy of the prostate, with a prior dental extraction described four weeks prior to arrival. Findings on initial ED presentation and subsequent hospitalization revealed infective spondylodiscitis, endocarditis, and brain abscess formation. This is the only cases noted in literature with all three infection locations with dual risk factors of dental and prostate procedures prior to symptom onset. This case highlights the multifocal illness that can complicate Abiotrophia defectiva infections, and the importance of thorough ED evaluation and multiservice approach for consultation and treatment.