SUBACUTE BACTERIAL ENDOCARDITIS: ACTIVE CASES WITHOUT BACTEREMIA
Authors: Chester S. Keefer
Journal: Annals of Internal Medicine (1937)

Article1 November 1937SUBACUTE BACTERIAL ENDOCARDITIS: ACTIVE CASES WITHOUT BACTEREMIACHESTER S. KEEFER, F.A.C.P.CHESTER S. KEEFER, F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-11-5-714 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptFor several years I have been interested in the group of patients with active bacterial endocarditis without bacteremia during life. These cases are not infrequent, and since organisms can be isolated from the vegetations post mortem, it is a matter of some interest to gather more information regarding the nature of the local lesion in the valves and the mechanism concerned with the absence of bacteremia.The relative incidence of these so-called "bacteria free"†1cases varies in the experience of different observers. In the last 54 cases of endocarditis which came to necropsy at the Boston City Hospital,‡the blood...References1. 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KEEFER, F.A.C.P.Affiliations: Boston, Massachusetts*Read before the St. Louis meeting of the American College of Physicians, April 23, 1937.From the Thorndike Memorial Laboratory, Second and Fourth Medical Services (Harvard), Boston City Hospital, and the Department of Medicine, Harvard Medical School, Boston.†The term "bacteria free" cases was first introduced by Libman.2 Sometimes it refers to cases without bacteremia but with organisms in the heart valves. In other instances, the term has been further restricted to those cases in which one can not obtain bacteria from the heart valves at necropsy (healing or healed bacterial endocarditis).‡I am indebted to Dr. Parker, Director of the Mallory Institute of Pathology, for allowing me to use the records for this information. He has also been very generous in studying the sections of the heart valves with me. 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