Catastrophic case of suppurative, embolic and fistulating infective endocarditis causing complete heart block

Complete heart block, aortic root abscess and aortic valve regurgitation are well-recognized complications of infective endocarditis of the aortic valve. Splenic abscess and aorto-cavitary fistula are rarer phenomena and are indicative of calamitous infection. The authors present the case of an otherwise healthy 61-year-old man presenting with a 2-month history of non-specific symptoms, who developed suppurative endocarditis with a fistulating aortic root abscess, combined with severe sepsis, splenic embolization and complete heart block. Staphylococcus lugdunensis was the causative bacterium identified. The combination of these sequelae in the same patient is sparsely reported, is exceedingly rare and carries a significant risk of mortality. Plain language summary: Infective endocarditis is a condition caused by bacteria invading the body and damaging the heart, especially the heart valves. Usually, the infection is diagnosed relatively swiftly by blood tests and images of the heart. Rarely, if this condition isn't managed promptly, the infection can progress to cause further damage to the heart and can spread to other organs and lead to a plethora of complications. Here, the authors report a case of a single patient who sought medical attention after 2 months of feeling unwell. It transpired that the patient had infective endocarditis that had spread to the spleen, which caused a defect in the cardiac tissue and impaired its ability to maintain an adequate circulation.