Enterococcal Endocarditis Presenting as an Isolated Aortic Valve Aneurysm: Case Report and Review of Literature

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A 53-year-old man who presented with an embolic stroke was found to have new mild to moderate aortic valve regurgitation on transthoracic echocardiography. Subsequent transesophageal echocardiography revealed an isolated aortic valve aneurysm, without evidence of valve vegetations. Four of 4 blood cultures grew Enterococcus faecalis. This unique case represents the first report of an aortic valve aneurysm associated with enterococcal endocarditis. An important teaching point is the need to investigate for endocarditis in patients with valve aneurysms of unknown etiology, even in the absence of valve vegetations on transesophageal echocardiography.

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