Polymicrobial native valve endocarditis due to and .

We present a case of polymicrobial subacute bacterial endocarditis and bacteremia with and in a 72-year-old man with pre-existing mitral valve disease and prior mitral valve repair who presented with renal failure and glomerulonephritis. is often a contaminant in blood cultures but has been rarely implicated in patients with invasive infections such as endocarditis. Intravenous drug use, prosthetic heart valves, valvular heart disease and venous catheters are the most frequently described risk factors for bacteremia and endocarditis in the medical literature. Management is challenging as is resistant to penicillin and cephalosporin antibiotics due to production of beta-lactamase. Polymicrobial endocarditis is uncommon and when it occurs typically involves species. To our knowledge, this is the first reported case of polymicrobial endocarditis in which both and a HACEK organism are implicated.