A Cerebrovascular Accident in the Setting of Kingella kingae Infective Endocarditis: A Case Report

<i>Kingella kingae</i>, a rare member of the <i>Haemophilus</i>, <i>Aggregatibacter</i>, <i>Cardiobacterium</i>, <i>Eikenella</i>, and <i>Kingella</i> (HACEK) group, is an uncommon cause of infective endocarditis (IE) in adults. Advances in molecular diagnostics, including polymerase chain reaction (PCR) and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), have significantly improved its identification. We present the case of a 78-year-old immunocompromised woman who developed watershed territory cerebral infarctions in the setting of <i>K. kingae</i> endocarditis. The patient initially presented with fever, altered mental status, and right-sided weakness and was later found to have <i>K. kingae </i>bacteremia, as well as a 7 mm aortic valve vegetation. Due to high surgical risk, the patient was managed conservatively with long-term intravenous antibiotics. This case highlights how modern diagnostic tools facilitate early detection of atypical pathogens and allow for more timely non-surgical management in vulnerable populations.