Acute Infective Endocarditis Due to Streptococcus gordonii in a Young Patient with a Bicuspid Aortic Valve

: Infective endocarditis (IE) is a life-threatening infection of the endocardial surface, often affecting individuals with predisposing cardiac abnormalities or recent invasive procedures. This report describes a rare case of acute IE in a previously healthy 22-year-old male with a bicuspid aortic valve and recent dental work, who presented with prolonged fever, myalgias, and peripheral embolic signs. Blood cultures confirmed Streptococcus gordonii as the causative pathogen, a virdans group streptococcus commonly associated with dental flora. Transthoracic and esophageal echocardiography revealed a bicuspid aortic valve with severe aortic insufficiency and a 1cm vegetation with suspected valve perforation. The patient was treated with a four-week course of intravenous ceftriaxone and referred for surgical management. Given the extent of valvular damage and the patients age, a Ross procedure was elected for the most appropriate surgical intervention. This case highlights the need for high clinical suspicion for IE in patients with recent dental procedure, even in the absence of typical risk factors, and emphasizes the importance of early diagnostic imaging and multidisciplinary management.