Dear Editor, We write to acknowledge and thank Dr O. Jolobe for his Letter to the Editor in response to our recently published article, 'Multivalve infective endocarditis in intravenous drug using patients: an epidemiological study'. We welcome the invitation to expand on our tertiary centre's experience with multivalve infective endocarditis in three key areas: the pattern of valvular involvement in multivalve endocarditis in intravenous drug using (IVDU) patients, the presence of cardiac shunts in those patients found to have bilateral endocarditis and embolic complications in patients with bilateral endocarditis. Of the 79 patients treated for IVDU-associated infective endocarditis at St Vincent's Hospital Melbourne between 1999 and 2015, 15 patients had multi-valvular endocarditis. Seven of these patients had unilateral endocarditis, and eight patients had bilateral endocarditis. The pattern of valvular involvement is outlined in Table 1.
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