SUMMARYA 49-year-old man presented to our department with an acute history of right leg tenderness, rash, swelling and fever. CT of the chest, abdomen and pelvis and a transoesophageal echocardiogram confirmed the diagnosis of mitral valve infective endocarditis with distal splenic emboli. Positive blood cultures revealed the causative organism to be Streptobacillus moniliformis. The patient was treated with high-dose antibiotics and had mitral valve replacement surgery. BACKGROUND