Patient was readmitted to the hospital and treated with cefepime and metronidazole. Positive physical findings were the presence of a high pitched decrescendo diastolic murmur and widened pulse pressure. Transesophageal echocardiogram showed mobile echogenic lobulated mass of the non-coronary cusp of aortic valve with resultant severe aortic insufficiency. The patient received an aortic valve replacement. He was discharged with 6 weeks of intravenous ceftriaxone. CK endocarditis is rare in immunocompetent adults. Our literature search yielded only four prior case reports. Based on our patient's urinary symptoms at presentation along with evidence of pyuria and bacteriuria, this patient's principle infection was likely genitourinary in nature. In conclusion, it is important for clinician's to closely monitor patients with CK bacteremia. If patients have underlying valvular disease, the development of vegetation can be rapid and can be fatal if left undetected.
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