We report a case of Staphylococcus aureus endocarditis with late onset in a 39-year-old male drug abuser, who presented with bacterial meningitis. Despite resolution of the meningitis as the result of appropriate antimicrobial chemotherapy he developed triple valve endocarditis. Some striking features of this case and a comparison with other reported cases of this uncommon presentation of infective endocarditis are discussed.

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