Infective endocarditis (IE) is the result of infection and damage to the endocardium of the heart due to either a cardiac structural abnormality or risk factors such as injection drug use, indwelling catheters, poor dental hygiene, or infection with HIV. IE most commonly involves the mitral valve and has 3 main classifications. Native valve endocarditis is the most common form (59% to 70%) and most often affects patients with mitral valve prolapse, bicuspid aortic valve, calcific aortic stenosis, or rheumatic heart disease. Streptococcus viridians, Staphylococcus aureus, and enterococcus are most commonly involved with mortality rates from 16% to 27%. Endocarditis involving injection drugs is the second classification and has an estimated incidence of 2% to 5%. There is a predilection for the tricuspid valve and is associated with high recurrence and mortality rates, particularly in HIV patients. S aureus is the main pathogen. Prosthetic valve endocarditis affects 1% to 4% of valve recipients within a year of surgery. It is divided in to early (<60 days post op) and late (>60 days). Early disease is usually nosocomial involving Staphylococcus epidermis and almost twice the mortality, whereas late is typically community acquired.