From Cardiac Mystery to Dental Discovery: Resolving Recurrent Infection in a Prosthetic Heart Valve Patient

We present the case of a 71-year-old female with a history of surgical bioprosthetic aortic valve replacement who developed a liquefactive abscess near the mitral valve trigone following Streptococcus gallolyticus bacteremia. The patient initially presented with dyspnea and symptoms of an upper respiratory tract infection. A trans-esophageal echocardiogram revealed mitral valve vegetation and a possible source of sepsis near the prosthetic aortic valve. However, it was the identification of multiple silent dental abscesses during a routine dental check-up that led to the resolution of the patient's symptoms and the eradication of the infectious process. This case highlights the importance of considering dental infections as a potential cause of recurrent bacteremia and infectious complications in patients with prosthetic heart valves.