Streptococcus pneumoniae in an infrequent cause of bacterial endocarditis in adults. The classic presentation is Osler´s tetrad of pneumonia, meningitis, endokardititis in an alcoholic. The course of pneumococcal endocarditis is typically aggresive and is associated with high morbidity and mortality rates. The mortality is reduced if is it managed with a combined medical-surgical aproach as compared with pure medical aproach. We present complicated case of pneumococcal endocarditis. We emphasisze the very important role of TEE in the management of severe pneumoccal infection.