eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2015-04-14 3 5 121 125 10.12691/ajmcr-3-5-1 AJMCR2015351 article Margret Jona Einarsdottir margjone@landspitali.is 1 Hildur Gudmundsdottir 2 Bjarni Torfason 2 3 Anna Thorisdottir 3 Karl Andersen 3 3 Thordis Jona Hrafnkelsdottir 3 3 Sigurdur Gudmundsson 3 3 Landspitali University Hospital, Reykjavik, Iceland His?y Legesenter, Kolbj?rnsvik, Norway We report a case of prosthetic valve nocardia endocarditis. A 43 year old farmer underwent aortic valve replacement with a bioprosthetic valve. The immediate post-operative course was uneventful but 2 weeks later he developed fever. A trans-oesophageal echocardiogram (TEE) showed a string like structure attached to the prosthetic valve. Blood cultures grew N. farcinica. He was initially treated with trimethoprim/sulfamethoxazole (TMP/SMZ), but due to eosinophilia and leucopenia his treatment was changed to imipenem and amikacin. He developed a rash, presumed to be due to imipenem, which was then substituted with linezolid. He completed a 6 week course of intravenous (i.v.) antibiotics. Desensitization with amoxicillin/clavulanic acid was successful and the patient received oral amoxicillin/clavulanic acid for 6 months. At present, 12 months from diagnosis, he is afebrile and TEE is normal. To our knowledge, this case is the fifth reported case of successful treatment of prosthetic valve nocardia endocarditis treated without surgery. http://pubs.sciepub.com/ajmcr/3/5/1/ajmcr-3-5-1.pdf prosthetic valve endocarditis Nocardia farcinica