Mechanical Valve Endocarditis and Dehiscence from Aggregatibacter actinomycetemcomitans Bacteremia

HACEK are gram negative organisms that are typically part of the oropharyngeal flora and are responsible for 1-3% of infective endocarditis cases. We describe an instance of multivalvular endocarditis caused by Aggregatibacter actinomycetemcomitans, which led to mechanical aortic valve dehiscence. Aggregatibacter actinomycetemcomitans represents approximately 20% of HACEK endocarditis cases and are exclusively found as part of normal oropharyngeal flora and break the vascular boundary during routine oral hygiene or plaque buildup. Antibiotics for 4-6 weeks with ceftriaxone is the mainstay of antibiotic therapy with surgical intervention reserved for those with valve dysfunction resulting in refractory heart failure.