Unusually extensive and diverse case of infective endocarditis

We present the case of a 74-year-old man originally scheduled for planned surgical aortic valve replacement due to suspected infective endocarditis on a severely stenotic valve. Blood cultures revealed Enterococcus faecalis and Klebsiella pneumoniae (ESBL+). Logistic Euroscore was 9.11% and STS for isolated AV replacement (AVR) showed mortality risk 2.539% and 21.784% morbidity or mortality risk, respectively. AVR procedure was performed with mini-thoracotomy approach, ESP 100-21 mm SJM prosthesis was implanted. On the 10th day following the procedure fever spikes with CRP and WBC elevation reoccurred and further course of the disease with all its capabilities was rather unfortunate and ended up fatally.