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To the Editor.—Actinobacillus is part of the HACEK group of gram-negative bacilli, and the species usually associated with endocarditis is Actinobacillus actinomycetemcomitans.¹ Most other Actinobacillus species are commensal organisms in domestic animals. Human infection is rare and usually occurs as a result of traumatic inoculation. Actinobacillus suis and Actinobacillus hominis are difficult to differentiate.² We report the first case, to our knowledge, of infective endocarditis caused by Actinobacillus organisms resembling A suis and A hominis. The patient's course was protracted because both the organism and the cardiac involvement were initially overlooked.

Report of a Case

A previously healthy 54-year-old man who was a professional hunter presented with high temperature and altered mental status. He last dressed meat from wild pigs 6 months previously. Four days before admission to the hospital he felt weak and developed abdominal pain, nausea, vomiting, chills, fever, diarrhea, and left upper extremity weakness. On examination the patient appeared anxious . . . [Full Text of this Article]