# Bicuspid Aortic Valve Endocarditis Caused by Streptococcus sanguinis: A Case Report

## TL;DR

A patient with a bicuspid aortic valve developed heart infection after a dental cleaning, suggesting a need for antibiotic prophylaxis.

## Contribution

This case highlights the potential risk of infective endocarditis in bicuspid aortic valve patients following dental procedures.

## Key findings

- A 63-year-old male with BAV developed IE caused by Streptococcus sanguinis after a dental cleaning.
- The patient required urgent aortic valve replacement due to severe aortic regurgitation.
- The case suggests BAV patients may benefit from antibiotic prophylaxis during dental procedures.

## Abstract

Antibiotic prophylaxis prior to dental work in bicuspid aortic valve (BAV) patients is currently a matter of debate. The American Dental Association does not require those with native BAV to receive antibiotic prophylaxis prior to dental work as BAV is considered an “intermediate” risk for infective endocarditis (IE). We present the case of a 63-year-old male, with a medical history of BAV, who acquired Streptococcus sanguinis IE after a routine dental cleaning four months prior to initial onset of symptoms. He exhibited new-onset and severe aortic regurgitation at presentation, requiring urgent aortic valve replacement to restore valve function. BAV patients are at high risk of IE, emphasizing the need for prophylactic antibiotics in dental cleaning as well as invasive dental procedures in those with BAV.