Infective endocarditis (IE) caused by Gram-negative bacilli (GNB) not included in the HACEK group (Haemophilus, Actinobacillus, Cardiobacterium, Eikenella corrodens, Kingella) is a rare infection that accounts for approximately 2% of all IE and is characterized by high mortality [1]. For several decades this infection has been associated with injecting drug use (IDU) [2]. However, in the last 15 years, an epidemiological transition has been observed resulting in a greater relationship with advanced age, immunosuppression, and nosocomial acquisition [3–6].