Abstract
Abiotrophia defectiva is nutritional deficient streptococci that cannot be cultured on routine culture medias. Even though fastidious in growth requirement, it is a virulent bacterium preferentially affecting endovascular structures and is implicated in many culture-negative endocarditis cases. Unlike other organisms, it is known for heart valve destruction leading to heart failure and excessive embolization rates. It's inherent resistance to routinely used antibiotics also contributed to increased mortality and morbidity in affected individuals and warrants timely diagnosis and prompt treatment. Our patient, a previous healthy individual, acquired this rare bacterium from intravenous drug abuse and developed infective endocarditis with valve destruction, heart failure, and distal embolization to multiple organs. He underwent multiple surgeries including mitral valve replacement and embolectomy with clinical improvement. Our case reiterates the possibility of rare cause of common diseases and raises awareness of infective endocarditis caused by A. defectiva among medical professionals.