SUMMARYThis report describes the first documented case of Erysipelothrix rhusiopathiae endocarditis in Latin America. The patient was a 51-years-old male, moderate alcoholic, with a previous history of aortic failure. He was used to fishing and cooking as a hobby and had his left hand wounded by a fish-bone. The disease began with erysipeloid form and developed to septicemia and endocarditis. He was treated with antibiotics and surgery for aortic valve replacement. There are only 46 cases of E. rhusiopathiae endocarditis reported to date. The authors wonder if several other cases might go unreported for lack of microbiological laboratorial diagnosis.KEY WORDS: Erysipelothrix, Endocarditis, Erysipeloid. CASE REPORTA 51-years-old white male was admitted to Hospital Mãe de Deus on November 30, spring of 1987, for evaluation of unexplained fever. He was a retired, mild alcoholic, who used to fish and cook as a hobby. On October 12, while cleaning some fish, he had gashed his left hand thumb, developing probable erysipeloid disease that was not detected at the time. Fifteen days later, his right foot showed signs of infection, with an erythematous lesion. His doctor prescribed corticosteroid and erythromicin for 2 days. Articular pain and astenia persisted and about 3 weeks later patient had sudden thoracic pain and a cough with ferruginous sputum. He was admitted to a hospital with a diagnosis of pneumonia and received daily doses of oxytetracycline while in the hospital. He was discharged on the seventh day but, as fever persisted, he went to Hospital Mãe de Deus. He reported feeling articular pain, dyspnea on effort and astenia. Several years earlier he had been told to have a heart murmur. When admitted, he had a fever of 37.6°C. Physical examination showed a well-fed man, with slightly discoloured mucous membranes; sistodiastolic aortic murmur + + /6; crepitation on the base of the right lung; no hepato or splenomegalies, no haemorrhagic suffusions; blood pressure 110/60 mmHg; bilateral pulmonar infiltration evident on chest X-ray; normal electrocardiogram; white blood cells count 5.000/cu.mm; normal differential count, haematocrit 32% and haemoglobin 10.2 mg/dl; erythrocyte sedimentation rate 112 mm/hr.