Streptococcus agalactiae Endocarditis Involving the Tricuspid Valve and Device Leads in a Patient With an Automated Implantable Cardioverter-Defibrillator (AICD).

Infective endocarditis involving cardiac device leads remains a serious complication in patients with intracardiac hardware, particularly in the setting of bacteremia. We present a case of a 47-year-old female with heart failure with reduced ejection fraction (HFrEF) and an automated implantable cardioverter-defibrillator (AICD) who developed Group B Streptococcus (Streptococcus agalactiae) bacteremia with evidence of both lead-associated and tricuspid valve vegetations. The case highlights diagnostic challenges in transthoracic echocardiography (TTE), multidisciplinary management, and the role of early device extraction in such cases.