Case Study 15 Scenario J.F. is a 50-year-old married homemaker with a genetic autoimmune defi ciency; she has suffered from recurrent bacterial endocarditis. The most recent episodes were a Staphylococcus aureus infection of the mitral valve 16 months ago and a Streptococcus mutans infection of the aortic valve 1 month ago. During this latter hospitalization, an ECG showed moderate aortic stenosis, moderate aortic insuffi - ciency, chronic valvular vegetations, and moderate left atrial enlargement