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In this case, late discovery, disease severity, and under treatment all contributed to the poor outcome. We want to share the knowledge on the existence of this bacteria. © The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.Background Patients with low levels of antithrombin III (AT III) are at an increased risk of developing arteriovenous thromboembolic disease. Case summary We report a case of a 28-year-old woman who presented with a 1-week history of spontaneous right calf pain and swelling. A heter