Prosthetic heart valve endocarditis caused by Bacillus circulans

We report a case of prosthetic valve endocarditis due to Bacillus circulans in a 56-year-old woman, pre-operative blood cultures were negative and the organism was only recovered on culture of the explanted mechanical valve. We discuss the reasons far the late clinical presentation of this ease, 15 months post valve replacement, caused by an organism which is conventionall y regarded as 'early' pathogen, The patient recovered well post surgery on a 6 week course of trimethoprim and ciprofloxacin. (C) 1999 The British Inf ection Society.