Case Report: Endocarditis Outside of the Europe-African Gradient: Comprehensive Review of Cases within North America.

Clinical syndromes associated with infection can be insidious and difficult to diagnose for multiple reasons. Clinically, can manifest as asymptomatic bacteremia or with subtle subacute constitutional symptoms. Second, it is a fastidious organism that is difficult to identify using traditional culture methods. Last, the body lice vector of transmission is likely not uncommon in most patients affected, who are homeless and of low socioeconomic status. Therefore, barriers in seeking medical care and financial constraints for medications are important considerations. The mainstay of literature surrounding endocarditis is from Europe and the developing nations. Herein, we describe a case of native valve endocarditis secondary to in a homeless male with preexisting valvular disease and undertake a comprehensive literature review of documented endocarditis in North America.