A proportional hazards regression analysis showed a survival benefit at 1 year for device removal during the initial hospitalization; device removal during the index hospitalization had died at 1 year, versus 13 of 34 (38.2%) who did not undergo device removal (HR: 0.42; 95% 7. Relapsing infections may be caused by incom- plete sterilization of valvular or paravalvular tis- sue secondary to a deep tissue infection. Even in the absence of other indications for intervention, such as severe valve dysfunction or a resistant organism, if there is no other source for persis- tent bacteremia, heart valve infection must be presumed to be the source. If the source of infec- tion is uncertain, additional imaging with PET/CT may be helpful in decision-making.7 8. The incidence of drug use associated IE continues to rise, with a known risk of IE that is 100-fold higher than that of the general population. In a National Institutes of Health sponsored state- wide health survey in the state of North Carolina, 42% of all IE valve surgeries performed between 2007 and 2017 were undertaken in patients with injection drug use related IE. The care of these patients is associated with longer hospital stays, higher readmission rates, higher rates of recurrent IE, and higher costs of care. With evolving sci- ence in addiction medicine, there is evidence that referral to addiction therapy can reduce mortality and morbidity rates in these patients. In patients admitted with drug use associated endocarditis, addiction specialists are an integral part of the 9. Embolic events are associated with increased morbidity and mortality in IE and occur in 20% to 40% of patients with IE. The risk of embo- lism is highest during the first days after initia- tion of antibiotic treatment and decreases after 2 weeks. 