Left-sided endocarditis in intravenous drug users: a case report and review of the literature.

We report a case of staphylococcus endocarditis of the mitral and aortic valves in an intravenous drug user (IVDU) complicated by abscess of the aortic root and aorto-left atrial fistula. Interestingly, the tricuspid valve was free of vegetation. Infective endocarditis in IVDUs more commonly involves right-sided valves; left-sided endocarditis is rare, indicates severe disease, or is a postmortem finding. This case illustrates the need for considering left-sided valve endocarditis in IVDU with septicemia, even if the tricuspid valve shows no evidence of vegetation.