Severe Anemia in a Case with Chronic Kidney Disease and Mechanical Heart Valve

Introduction: Infective endocarditis is a serious disease with high morbidity and mortality, especially when associated with renal failure. Anemia is a common finding in chronic kidney disease. Here, we present a case of renal failure and severe anemia with a complicated mechanical heart valve infection with a Delayed diagnosis. Case Presentation: A 68-year-old male patient with a history of chronic kidney disease and metallic aortic valve surgery presented with fever, severe anemia, and about 10-kg weight loss that eventually revealed infective endocarditis in echocardiography with significant valvular leakage, pseudoaneurysm of mitral-aortic intervalvular fibrosa and a fistula to left ventricular outflow tract and sinus Valsalva of the aorta. Conclusions: This case report indicates that anemia, renal failure, and fever of unknown origin can be one of the diagnostic signs of endocarditis. It is important to consider infectious endocarditis in high-risk patients because late diagnosis greatly increases mortality, serious complications, and morbidity.