35 yr old male, fever 99-100 degrees F lasted for 3-4 days, spells of weakness, slight headache, no nausea or vomiting. anemic, white count of over 15000 cells, esr is 58 mm/hr, elevated protein, TTE shows vegetation on atrial surface of the atrioventricular valve, blood culture show gram positive bacteria. wisdom teeth removed 2 weeks ago.