A 69-year old man presented with a 2-week history of back discomfort and fevers, having had bioprosthetic aortic valve replacement (AVR) for prosthetic valve infective endocarditis (PVE) 4-months ago. Past medical history included coronary artery bypass grafting in 2008, bioprosthetic AVR with root replacement for ascending aortic dissection in 2010, diabetes mellitus, and chronic renal impairment. In June 2016, he was admitted with Streptococcus mitis bacteraemia treated with 6 weeks of ceftriaxone. Transoesophageal echocardiography was negative for endocarditis and root abscess. In November 2016, the patient was admitted with heart failure secondary to new severe aortic regurgitation. Transoesophageal echocardiography showed dehiscence of the anterior leaflet of aortic valve prosthesis. Blood cultures were negative. He was commenced on vancomycin prior to re-do AVR and discharged on lifelong amoxycillin.