Science and Education Publishing American Journal of Medical Case Reports 2374-216X 4 6 2016 6 22 Acute Embolic Ischemic Stroke as the Sole Presentation of Subacute Enterococcal Endocarditis 212 214 EN Hassan Tahir Department of Internal Medicine, Temple University/ Conemaugh Memorial Hospital, Johnstown PA, USA Muhammad Ali Raza Vistasp Daruwalla Zeeshan Khakwani AJMCR2016467 10.12691/ajmcr-4-6-7 2016 2 22 2016 5 18 2016 6 20 Neurological complications are the most frequent extra cardiac complications of infective endocarditis (IE) dominated by the stroke with a high mortality . These manifestations might be the first sign of IE in rare cases. Atrial fibrillation and infective endocarditis (IE) are two of the most common causes of cardio embolic strokes. The patients with infective endocarditis (IE) can present with variable symptoms ranging from vague complaints of fever and chills to any embolic complication. Duke's criteria is the most common criteria used to diagnose infective endocarditis. We present a case of an acute ischemic stroke in a young patient, which was the sole presentation of subacute infective endocarditis associated with Enterococcus faecalis, thus leading to delayed diagnosis and treatment.