Mycobacterium abscessus causing native aortic valve endocarditis post stenting.

Native valve endocarditis owing to Mycobacterium abscessus (M. abscessus) is extremely rare and only a few cases have been reported in the literature. We present a case of a 44-year old male patient, a coronary artery disease (CAD) case with a stent in situ with pyrexia of unknown origin (PUO). He started becoming febrile following placement of stent and continued to remain febrile for duration of five months before coming to our centre. Echocardiogram showed vegetations on the aortic valve and paired blood cultures grew M. abscessus. Antibiotics including Clarithromycin were added to his treatment and a valve replacement was planned. The patient underwent valve replacement, however succumbed to the illness despite best efforts. It is difficult to diagnose M. abscessus in Gram stain as they appear as diphtheroids and may be interpreted as contaminants. Even an accurate diagnosis makes this organism difficult to treat. Early surgical intervention along with aggressive antibiotic therapy is recommended for treatment.