The relative absence of Streptococcus sanguis in human feces, in contrast to its high concentration on teeth, supports the concept of the mouth as the likely bacterial source in cases of subacute bacterial endocarditis involving this organism.

The elderly constitute an increasing percentage of patients with infective endocarditis. The disease manifestations and outcomes in 53 episodes of endocarditis in patients over the age of 60 were reviewed and compared with 55 episodes of endocarditis in patients less than 40 years of age and 46 episodes of endocarditis in patients aged 40 to 60. The percentage of cases caused by staphylococci a...

Antibiotic prophylaxis for prevention of infective endocarditis has long been recommended for patients receiving dental care. Two studies of patients with endocarditis found limited risk associated with dental treatment. It is imperative that guidelines for therapy be based on outcome studies and on evidence of safety, efficacy and cost effectiveness.

Horder (1909) reviewed 150 cases of subacute bacterial endocarditis at all ages and found that congenital heart lesions were present in eight (5-3 ). In 250 similar cases reviewed by Kelson and White (1945) there were 13 (5-2%) congenital heart lesions, and in a further 88 cases seen between 1939 and 1944 White, Mathews and Evans (1945) recorded 12 (13%), whilst Seabury (1947) put the incidence...

Leptotrichia species are normal constituents of the oral cavity and the genitourinary tract microbiota that are known to provoke disease in immunocompromised patients and rarely in immunocompetent individuals. Following the description of Leptotrichia goodfellowii sp. nov., two cases of endocarditis by this species have been reported. Here, we report a case of Leptotrichia goodfellowii endocard...

Infective endocarditis in pregnancy has a low incidence, often being associated with a previous history of rheumatic or congenital heart disease. In most reports the disease tends to run a subacute course and to appear more frequently in the third trimester of pregnancy. We present the case of a 36-year-old woman with large vegetations on the mitral valve due to infective endocarditis detected ...

A case of subacute bacterial endocarditis due to Actinobacillus actinomycetemcomitans is reported. The patient was successfully treated first by a combination of gentamicin and ampicillin and then, because of severe allergic reactions, ampicillin was replaced by co-trimoxazole; symptoms did not recur and blood cultures remained sterile. A synoptic table is presented of 19 reported cases of infe...

Libman-Sacks endocarditis is a classic but rarely symptomatic manifestation of systemic lupus erythematosus, and valvular surgery is needed in a few cases. We present a patient with systemic lupus erythematosus and Libman-Sacks endocarditis that progressed rapidly to severe mitral regurgitation that needed surgery; surgical valve repair was decided upon. The literature on this topic is reviewed.

Serum concentrations of cephalothin or kanamycin, or both, were determined in 53 patients undergoing cardiopulmonary bypass. Conventional doses of these antibiotics did not provide serum levels above the accepted minimum inhibitory concentrations in children. Adults had adequate serum antibiotic concentrations only when the antimicrobials were administered within 4 h of beginning cardiopulmonar...

An adult man presented severely ill with vasculitis of his lower extremities and with impaired kidney function. After detailed evaluation at a local hospital, a diagnosis of essential type III cryoglobulinemia was made. High-dose steroid and cyclophosphamide therapy was begun. The patient improved dramatically. However, 6 wk later when his steroid dose was reduced to 30 mg daily, vasculitis rec...