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An aggressive form of We present the case of a 49-year-old man with a bicuspid aortic valve who presented to the emergency department with limb weakness and a fever. Blood tests revealed a fulminant septic process with Haemophilus parainfluenzae bacteraemia, anaemia and thrombocytopenia. Imaging revealed a cervical spinal abscess and discitis causing spinal cord compression, in addition to multiple cerebral septic emboli, pleural effusions and ascites. A transoesophageal echocardiogram (TOE) performed post decompression of his spinal collection showed native aortic valve endocarditis with an associated large aortic root abscess. He underwent successful aortic valve surgery and a 6-week course of antibiotic therapy and made an excellent clinical recovery with no long-term complications from his condition.