From RK MD:

Here’s what an aortic valve completely destroyed by infective endocarditis (IE) looks like. 
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"Endocarditis” is an inflammation of the inner lining of the heart but usually refers to a valvular infection. Risk factors can include recent dental/surgical interventions, IV drug use or indwelling IV catheters (ie, PICC lines), any immunosuppressed state, and a prior history of IE. The modified Duke clinical criteria formally stratify the likelihood of “DEFINITE IE” in the presence of 2 major, 1 major and 3 minor, or 5 minor criteria. 
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MAJOR CRITERIA:
Two blood cultures spaced > 12 hours apart with bacteria typically implicated in IE (S. Aureus, Viridans strep, HACEK organisms, etc.)
New valvular insufficiency
Echo showing vegetations or abscesses
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MINOR CRITERIA:
Risk factors: IV drug use, prosthetic heart valve, etc.

Fever > 100.4°F (most common finding)

Immunologic findings: Roth spots, Osler nodes, etc.

Vascular findings: Janeway lesions, emboli, mycotic aneurysm, conjunctival hemorrhage

Infectious: blood cultures that don’t meet the major criteria
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Patients with IE are often very sick and require surgery to obtain adequate source control coupled with prolonged courses of antibiotics. I use transesophageal echocardiography (TEE) to assess the entire heart for vegetations on other valves, abscess cavities, perforations, etc. These patients can also be quite labile as they are actively septically superimposed on a heart with acute, uncompensated valvular changes.
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