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April 12, 1941


JAMA. 1941;116(15):1646-1647. doi:10.1001/jama.1941.02820150036012

Bacterial endocarditis has always been considered a fatal disease, although occasional spontaneous recovery has undoubtedly occurred. Libman cited 10 cases with positive blood cultures in which recovery had taken place. Capps, in a review of 139 cases, reported 11 in which survival continued for more than five years. He had not, however, seen a single recovery since 1924, which might suggest that there exists a variability in the virulence of causative organisms from year to year.

The discovery of the effect of sulfonamide derivatives on streptococcic infections naturally suggested their trial in cases of subacute bacterial endocarditis. Manson-Bahr1 reported an apparent cure from the intravenous administration of azosulfamide in 2 typical cases without positive blood cultures. In a case with a typical clinical picture and with Streptococcus viridans in blood cultures, Heyman2 used sulfanilamide and reported recovery of eighteen months' duration at the time of his report. Whitby