{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:53:38Z","timestamp":1782924818297,"version":"3.54.5"},"reference-count":27,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,5,23]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>\n                  <jats:italic>Abiotrophia defectiva<\/jats:italic> is a nutritional variant streptococcus, with affinity for endovascular structures that cannot be cultured on non-supplemented media, leading to a delay in diagnosis. This case describes a 36-year-old woman with a previously known bicuspid aortic valve that presented with asthenia, myalgias and anorexia with 2-month onset. On admission, we documented fever and a systolic murmur. Transthoracic echocardiography revealed an oscillating mass attached to the aortic valve. The patient was admitted with a possible diagnosis of infective endocarditis. Later, blood cultures were positive for <jats:italic>A. defectiva<\/jats:italic>. Due to severe aortic regurgitation and congestive heart failure, she underwent surgical aortic valve replacement. After 6 weeks of antimicrobial therapy, the patient experienced full recovery. Despite of its rarity, <jats:italic>A. defectiva<\/jats:italic> endocarditis is associated with significant morbidity with mortality and physicians must have a high level of suspicion to ensure a prompt diagnosis and provide the appropriate treatment.<\/jats:p>","DOI":"10.1136\/bcr-2021-241964","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T12:12:01Z","timestamp":1624277521000},"page":"e241964","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Infective endocarditis by a rare and fastidious agent: <i>Abiotrophia defectiva<\/i>"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0340-0072","authenticated-orcid":false,"given":"Ana Margarida","family":"Mosca","sequence":"first","affiliation":[{"name":"Internal Medicine, Hospital de Braga, Braga, 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