Nonsurgical Management of Mitral Valve Endocarditis Due to Cardiobacterium valvarum in a Patient with a Ventricular Septal Defect

Cardiobacterium valvarum is a relatively novel agent of infective endocarditis. We describe the first case of infective endocarditis due to this pathogen in the Asian Pacific. This case is unique in its involvement of the mitral valve as well as its clinical resolution exclusively resulting from treatment with antibiotics without resorting to valve replacement/explantation. CASE REPORT A 63-year-old Chinese female with a congenital perimembra-nous ventricular septal defect (VSD) presented with a com-plaint of 5 days of frontal headache, slurred speech, and vomiting. The patient was afebrile (37.1°C) and nonhypotensive (135-/ 70-mm Hg) on admission. The leukocyte count was 10.4 109/liter, the hemoglobin level was 10.5 g/dl, and the C-reactive protein (CRP) level was 79.8 mg/liter. Systemic examination was unremarkable ex-cept for poor dentition (dental caries) and a grade 5 pansystolic mur-mur secondary to severe mitral valve regurgitation. A computed tomatography (CT) scan of the brain demonstrated a frontotemporal subarachnoid hemorrhage. A subsequent 4-vessel cerebral angio-gram revealed a bilobed aneurysm from the parietal cortical branche