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April 1, 1974

Mitral Obstruction by Vegetations of Staphylococcal Endocarditis

Author Affiliations

From the Departments of Medicine, Kaiser-Permanente Medical Centers, Vallejo and San Francisco, Calif.

JAMA. 1974;228(1):75. doi:10.1001/jama.1974.03230260049026

ACUTE valvular insufficiency during active endocarditis is a well-recognized complication that may require surgical intervention. The development of acute valvular obstruction as a result of vegetations is a rare complication of endocarditis, and to our knowledge has not been treated surgically. Mitral obstruction caused by vegetations of bacterial endocarditis has been reported in only one patient, a 21-year-old woman with group B β-hemolytic streptococcal endocarditis.1,2 At physical examination, apical systolic and diastolic murmurs were heard. Autopsy disclosed a mildly scarred mitral valve with severe obstruction due to the vegetation alone. Roberts et al1,2 also reported one case of aortic obstruction caused by vegetations of Candida parapsilosis endocarditis of 11 months' duration in a 26-year-old narcotic addict and one case of possible tricuspid obstruction3 from the vegetations of Staphylococcus aureus endocarditis in a 35-year-old heroin addict.

We have observed a patient in whom severe mitral obstruction developed in