Question: A 60-year-old man with a past medical history significant for atrial fibrillation (AF) status post ablation in 2006 on warfarin, bicuspid aortic valve status post mechanical aortic valve replacement with subsequent elective surgical valve explant with bioprosthetic placement and aortic root patch repair for an aneurysm, and Maze procedure 4 weeks before presentation to the emergency room presented with fever, rigors, lethargy, and diaphoresis. Patient stated he was fatigued and had multiple fainting spells before his arrival.