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Psychological factors

The Duke Criteria for diagnosis of infective endocarditis: Requires 2 major + 1 minor OR 1 major + 3 minor OR 5 minor criteria for diagnosis * : Viridans streptococci, Streptococcus bovis and HACEK group OR Staph aureus/enterococci in the absence of a primary focus and persistently positive blood Cx defined as 2 blood Cx drawn 12 hours apart # : Positive echocardiogram for vegetations OR new valvular regurgitation The management of IE includes 4-6 weeks of high dose IV antibiotics

Discussion Methotrexate (MTX) is an everlasting medication used in a wide range of cancerous and benign maladies [43]

All human subjects are displayed in Supplemental Figure 6