Staphylococcus aureus endocarditis with fast development of aortic root abscess despite relevant antibiotics

We present a case of Staphylococcus aureus endocarditis in which a large abscess was formed in only 4 days, despite specific intravenous antibiotics and only few vague signs of disease progression. Our case seems to be the first to show echocardiographic documentation of how quickly an intracardiac abscess can develop despite relevant antibiotics. Clinically, the patient is remarkably unaffected, and thus even small signs of progression should lead to considerations about repeating the diagnostic imaging workup. This case illustrates how aggressive an infection S. aureus endocarditis may be, and therefore it should be treated by an experienced team with easy access to both transthoracic and transesophageal echocardiography.