BACKGROUND: Prosthetic valve endocarditis (PVE) represents a life-threatening infection that may complicate valve replacement, associated with high morbidity and mortality. There is no clinical presentation characteristic of PVE. Causative agents of community-acquired PVE include endogenous microbiota, such as viridans group streptococci and enterococci, similar to native valve endocarditis etiology. An increasing number of recent publications have addressed the pathogenic role of Achromobacter xylosoxidans, a causative agent of a wide range of opportunistic infections in immunocompromised patients and healthcare‐associated infections. However, it has only rarely been associated with the development of endocarditis, most commonly reported in patients with severe immune impairment caused by various pathological conditions or in very frail elderly patients.

CASE PRESENTATION: A severe aortic valve graft infection by A. xylosoxidans is described with a literature review. A 69-year-old man with multiple serious comorbidities developed severe aortic endocarditis due to A. xylosoxydans after aortic valve replacement surgery. Only treatment with daptomycin, gentamicin and ampicillin allowed to obtain long-term clinical improvement.

CONCLUSIONS: An extensive review of the literature on cases of A. xylosoxydans endocarditis was conducted. Our review highlights that PVE due to A. xylosoxydans has a high mortality.