A 47-year-old woman presented with isolated renal infarction of unknown etiology. Initial intravascular ultrasonography revealed emboli, not dissection, guiding successful renal artery intervention. Subsequent investigation, prompted by persistent fever and positive blood cultures, identified Cardiobacterium hominis as the causative agent of infective endocarditis. The diagnosis was confirmed by echocardiography showing vegetation on the aortic valve. This case highlights an unusual presentation of C. hominis endocarditis, where renal infarction was the primary symptom, emphasizing the need for a high index of suspicion in embolic events of unclear origin.
Key note: Cardiobacterium hominis endocarditis can present atypically, such as with isolated renal infarction, requiring thorough investigation.