Innocent Until Proven Guilty: Native Valve Staphylococcus lugdunensis Infective Endocarditis Complicated by Embolic...

Staphylococcus lugdunensis is a coagulase-negative staphylococcus (CoNS) with unique virulence traits that mimic Staphylococcus aureus, despite traditionally being grouped among less pathogenic skin flora. Unlike other CoNS, S. lugdunensis can infect native valves and cause aggressive infective endocarditis (IE). We present a rare and instructive case of S. lugdunensis native mitral valve endocarditis complicated by cerebral embolic infarctions and requiring surgical valve replacement in a patient on chronic peritoneal dialysis. This case underscores the diagnostic challenge of CoNS bacteremia, highlights the embolic potential of S. lugdunensis, and represents one of the few documented cases of stroke complicating S. lugdunensis IE in a dialysis-dependent patient without prosthetic devices.