Complete atrioventricular block revealing an infective endocarditis complicated to aortic abscess fistulized both in the aortic lumen and in the right ventricle

Cardiac abscesses and aorto-cavitary fistulas are rare and serious complications of infective endocarditis (IE). They can be complicated by high degree cardiac conduction abnormalities and by haemodynamic consequences which can be life-threatening. We report here the rare case of a young patient of 27 years who presented in a table of septic shock associated with a complete atrioventricular block (AVB), making it possible to make the diagnosis of infective endocarditis to Enterococcus Cloacae, which is a germ exceptionally responsible of infective endocarditis and known multiresistant; Complicated with abscess of the Valsalva sinus, which is extended to the interventricular septum and fistulized both in the aortic lumen and in the right ventricle. The patient has unusually well evolved under amoxicillin and gentamycin associated with surgical treatment. Conduction abnormalities and aorto-right ventricular fistulas testify to the severity and extent of the lesions of abscessed infective endocarditis. Mortality is high in this context.