Abiotrophia defectiva: A rare and lethal but an easy miss!

Abstract

Abiotrophia defectiva is a nutritionally deficient streptococci, a rare pathogen of infective endocarditis (IE) in children but is frequently known to cause valvular dysfunction and embolic complications. Only nine cases of A. defectiva endocarditis have been reported so far in world literature. We report a case of A. defectiva endocarditis in a 7-year old girl, with a small peri membranous ventricular septal defect with congenital bilateral sensorineural hearing loss status post left-sided cochlear implantation who presented with prolonged fever. A. defectiva should be considered in children with endocarditis with a subacute course and atypical presentations. Although fastidious in growth it is a virulent bacterium preferentially affecting endovascular structures and is implicated in many culture negative endocarditis. Our case reiterates the possibility of a rare cause of this common disease and the challenges encountered while isolating this nutritionally deficient organism and its treatment.