Case Presentation
A 60-year-old male with multiple medical including CLL, type 2 Diabetes Mellitus, hyperlipidemia, prostate cancer, and tobacco abuse, presented to the VA ED complaining of difficulty speaking and left arm weakness. No cardiac murmur was appreciated on physical exam and no focal neurologic deficits. Workup revealed a left parietal ischemic infarct. Further workup with Transthoracic Echocardiography revealed a trileaflet aortic valve with mild leaflet thickening and a calcified mobile mass on the aortic valve leaflets measuring 1.4 cm. Evaluation with Transesophageal Echocardiogram confirmed the mass. Cardiac surgery was consulted for a suspected fibroelastoma. There was low suspicion for endocarditis with no evidence of a systemic infection. The mass was excised for histopathological evaluation consistent with a Calcified Amorphous Tumor (Fig. 1). However, 16s rRNA and 18s rRNA sequencing detected Tropheryma whipplei, and the diagnosis of Whipple’s endocarditis was made. ­­­­­­