Infective Endocarditis Involving the Chiari Network

A 52-year-old male with a past medical history significant for hypertension, bipolar disorder, tobacco use, gout, homelessness, intravenous drug use, untreated hepatitis C (spontaneous clearance), and human immunodeficiency virus presented to the emergency department with complaints of left foot pain and lower back pain. He was found to have fever, mild leukocytosis, and blood cultures with positive methicillin-sensitive Staphylococcus aureus infection. Transesophageal echocardiography was performed to check for intracardiac vegetations due to high risk of infective endocarditis. A mobile echo density was seen attached to the Chiari network, leading to diagnosis of Chiari network endocarditis.