Infective Endocarditis Masquerade: Aortic Prosthetic Valve Degeneration and Mitral Prosthetic Valve Thrombosis Mimicking Infective Endocarditis.

We describe a unique case where a combination of aortic bioprosthetic failure, mitral bioprosthetic thrombosis and a previously untreated pseudoaneurysm of the intervalvular fibrosa mimicked infective endocarditis. Clinical examination, review of patient's history and old imaging studies together with an extensive negative infectious workup allowed the correct diagnosis and appropriate management. Multimodality imaging, including echocardiography, 4D-CT and PET-CT were critical in confirming a non-infectious etiology. TAKE-HOME MESSAGE: A unifying diagnosis of infective endocarditis was incorrect, with multiple diseases responsible for the clinical findings. This is yet another instance when Hickam's dictum trumps Occam's razor - all due to multimodality imaging.