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HACEK endocarditis — ABIM Board MCQ

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HardInfectious DiseaseHACEK endocarditisABIM Board

A 47-year-old man has fever and a new murmur 3 weeks after a dental abscess. Blood cultures grow Aggregatibacter aphrophilus. Transesophageal echocardiography shows a 1.2-cm mitral vegetation without abscess and mild regurgitation. He has no heart failure or embolic event. Which of the following is the most appropriate management?

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Correct answer: B — Ceftriaxone for 4 weeks

HACEK native valve endocarditis is generally treated with ceftriaxone for 4 weeks when susceptible and uncomplicated. Surgery is reserved for heart failure, uncontrolled infection, abscess, or embolic-risk features rather than organism name alone.

Reference: AHA/IDSA Infective Endocarditis Guidance