Conclusion
Vertebral osteomyelitis in the presence of persistent or recurrent bacteremia warrants screening for active infective endocarditis. This case report documents an embryological remnant of the inferior vena cava, known as the eustachian valve, as a source of infective endocarditis in the setting of vertebral osteomyelitis. While this constellation of comorbidities is rare, this case underlines the importance of a thorough evaluation and persistent monitoring in the treatment of such persistent infectious conditions.