<i>Aggregatibacter actinomycetocomitans</i> prosthetic valve endocarditis causing sequential transient ischaemic attack, rheumatoid factor-positive inflammatory polyarthritis and intracerebral haemorrhage

Subacute bacterial endocarditis is often associated with non-specific symptoms and multi-system embolic phenomena that can make diagnosis difficult. We present a case of <i>Aggregatibacter actinomycetocomitans</i> (<i>Aa</i>) prosthetic valve endocarditis, initially causing a transient ischaemic attack, inflammatory arthropathy, then intracerebral haemorrhage, the latter leading to diagnosis. <i>Aa</i> should be suspected in prosthetic valve recipients with sequential onset of inflammatory arthropathy and cerebrovascular disease.