case_images: PMC10188988_01
case_images: Head CT of the patient (A) the red arrow indicates infarction of the right basal ganglia. (B) The red arrow indicates subarachnoid hemorrhage.
case_images: fmed-10-1117474-g0001.jpg
case_images: PMC10188988_01_fmed-10-1117474-g0001.jpg
case_images: F1
case_images: A head CT scan urgently performed revealed a cerebral infarction in the right basal ganglia and a subarachnoid hemorrhage (Figure 1). According to antimicrobial susceptibility testing (Supplementary Figure 1), the bacteria were susceptible to vancomycin, clindamycin, and linezolid but resistant to penicillin, ceftriaxone, and cefepime. All three blood cultures tested positive for A. defectiva.
case_images: Transthoracic echocardiography examination of the heart in the patient. (A) THE red arrow indicates the vegetation (2.3 x 1.3 cm) on the mitral valve. (B) The red arrow indicates another position of the vegetation (2.3 x 0.7 cm) on the mitral valve. LA: left atrium; LV: left ventricle.
case_images: fmed-10-1117474-g0002.jpg
case_images: PMC10188988_01_fmed-10-1117474-g0002.jpg
case_images: F2
case_images: A transthoracic echocardiogram (TTE) revealed vegetation on the mitral leaflets measuring 2.3 x 1.3 cm (Figure 2).
case_images: Overview of Abiotrophia defectiva of growth morphology (A) Colony growth of A. defectiva on blood agar. (B) Smear showing gram-positive cocci in chains.
case_images: fmed-10-1117474-g0003.jpg
case_images: PMC10188988_01_fmed-10-1117474-g0003.jpg
case_images: F3
case_images: A. defectiva (Figure 3) with the Vitek MS using library v3.2 (bioMerieux, Marcy-l'Etoile, France) and the percent of identity is 99.9%.