Aggregatibacter actinomycetocomitans prosthetic valve endocarditis causing sequential transient ischaemic attack, rheumatoid factor-positive inflammatory polyarthritis and intracerebral haemorrhage

Subacute bacterial endocarditis is often associated with non-specific symptoms and multi-system embolic phenomena that can make diagnosis difficult. We present a case of Aggregatibacter actinomycetocomitans (Aa) prosthetic valve endocarditis, initially causing a transient ischaemic attack, inflammatory arthropathy, then intracerebral haemorrhage, the latter leading to diagnosis. Aa should be suspected in prosthetic valve recipients with sequential onset of inflammatory arthropathy and cerebrovascular disease.