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A transthoracic echocardiogram showed an aortic leaflet vegetation with chronic moderate aortic regurgitation but no reduction in his ejection fraction. He was discharged home and treated with gentamicin and penicillin G, initially with adequate response. However, he was subsequently readmitted for persistent fevers, chills, weight loss and dizziness, found to have multiple acute strokes secondary to septic thromboemboli. He underwent definitive aortic valve replacement with excised tissue confirming infective endocarditis.<\/jats:p>","DOI":"10.1136\/bcr-2022-252699","type":"journal-article","created":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T11:15:24Z","timestamp":1679310924000},"page":"e252699","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["<i>Lactobacillus rhamnosus<\/i> endocarditis associated with dental procedure in a patient with Marfan\u2019s variant and prior aortic root replacement"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2494-7867","authenticated-orcid":false,"given":"Michael","family":"Hovan","sequence":"first","affiliation":[{"name":"Department of Medicine, NewYork-Presbyterian Hospital\/Weill Cornell Medical Center, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari","family":"Mandler","sequence":"additional","affiliation":[{"name":"Department of Medicine, NewYork-Presbyterian Hospital\/Weill Cornell Medical Center, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,3,20]]},"reference":[{"key":"2025082701533213000_16.3.e252699.1","doi-asserted-by":"crossref","DOI":"10.1016\/j.idcr.2020.e00811","article-title":"Lactobacillus endocarditis: a case report in france and literature review","volume":"21","author":"Campagne","year":"2020","journal-title":"IDCases"},{"key":"2025082701533213000_16.3.e252699.2","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofx085","article-title":"Lactobacillus rhamnosus endocarditis after upper endoscopy","volume":"4","author":"Aaron","year":"2017","journal-title":"Open Forum Infect Dis"},{"key":"2025082701533213000_16.3.e252699.3","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-012-1599-5"},{"key":"2025082701533213000_16.3.e252699.4","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/15.2.250"},{"key":"2025082701533213000_16.3.e252699.5","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s10096-004-1253-y","article-title":"Pathogenic relevance of lactobacillus: a retrospective review of over 200 cases","volume":"24","author":"Cannon","year":"2005","journal-title":"Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol"},{"key":"2025082701533213000_16.3.e252699.6","doi-asserted-by":"crossref","first-page":"161","DOI":"10.14503\/THIJ-15-5121","article-title":"Bacterial endocarditis caused by lactobacillus acidophilus","volume":"43","author":"Encarnacion","year":"2016","journal-title":"Tex Heart Inst J"},{"key":"2025082701533213000_16.3.e252699.7","doi-asserted-by":"crossref","unstructured":"Patnaik S , Davila CD , Chennupati A , et al . 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