RT Journal Article SR Electronic T1 Multi-valvular infective endocarditis from Gemella morbillorum JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e242093 DO 10.1136/bcr-2021-242093 VO 14 IS 7 A1 Anish Kumar Desai A1 Erin Murchan Bonura YR 2021 UL http://casereports.bmj.com/content/14/7/e242093.abstract AB Gemella morbillorum is increasingly implicated in infectious endocarditis. Our patient presented with anaemia and renal failure with evidence of infarcts and embolic disease. He was found to have endocarditis with an organism that could not speciate with standard culture methods requiring matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF) for identification and susceptibilities. While involvement of mitral and aortic valves can be expected with Gemella, he had rare involvement of the pulmonic valve in a structurally normal heart. Although bacteriological cure was achieved, due to the locally destructive nature of Gemella, he ultimately required valve replacements for heart failure resolution. Workup for commonly implicated pathologies associated with G. morbillorum led to suspicion of gastrointestinal malignancy with findings of occult bleeding prompting an ongoing evaluation. With improved access to advanced diagnostics, G. morbillorum has been increasingly identified in infectious endocarditis. Given its destructive nature, it is important for clinicians to consider this organism is difficult to identify isolates.