Aortic Valve Replacement and Penicillin Desensitization in a Patient with Aortic Valve Endocarditis.

is an uncommon and insidious yet destructive cause of infective endocarditis preferentially treated with penicillin/gentamicin and often requiring surgical treatment. A 60-year-old man with penicillin anaphylaxis history presented with fevers and a nonspecific constellation of symptoms. He was ultimately diagnosed with bicuspid aortic valve infective endocarditis based on blood cultures growing and echocardiographic evidence of bicuspid aortic valve, severe valvular regurgitation, and 5 × 7 mm vegetation. Aortic valve replacement and culture yielded penicillin-sensitive . After successful penicillin desensitization, antibiotic therapy was switched from vancomycin/gentamicin to benzylpenicillin. This is the first published case of penicillin desensitization in a patient with -associated infection. Penicillin desensitization, optimal antibiotic therapy, prompt aortic valve replacement, and close collaboration between cardiology and various other specialties were essential in achieving a positive outcome.