Question: 36 year old male history of recent acute cellulitis in lower leg treated with antibiotics and cleared up. Before and after this he had Chronic 135 heart rate and feeling weak faint and ill. led to exam finding enlarged right atrium and new leaking mitral valve. No follow up. 2 months later ER visit for unexplained lesions on face, diagnose in ER as shingles and sent home. Lesions which were large, somewhat circular and brownishish with a middle area looking raw and dotted with small red dots. This resolved with 2 days antibiotic. But echo showed evidence of septal infarction age undetermined. Bacteria in blood - hospital discharged him with a script for a broad spectrum oral anti biotic. current heart rate has slowed however feelings of acute weakness and illness continue. Now chest discomfort. Patient had endocarditis 6 years ago, result of IV drug use. Patient had insurance the ER hospital did not accept. Please advise Patient was on Probation for drug issue and went out of county for proper rehab care. He was rearrested for this and removed from the rehab where there was medical care, and is now in county jail with no treatment. Best guess what is happening? I suspect endocarditis with distruction of mitral valve leading to septal infection Still no targeted antibiotic.