We present the case of a 71-year-old diabetic woman, suffering from chronic renal failure and with a history of hemodialysis for 6 years, who suddenly died. The autopsy showed a tamponade hemopericardium and a perforation of the left atrio-ventricular wall by an abscess of the mitral annulus. A severe picture of calcification of the mitral annulus calcification also emerged. Histology confirmed the abscess, highlighting the presence of peri-abscess endocarditis. Post-mortem microbiological investigations identified the presence of