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Article
February 1955

FATAL STAPHYLOCOCCAL ENDOCARDITIS TREATED WITH ERYTHROMYCINRapid Development of Resistance in Vivo and in Vitro

AMA Arch Intern Med. 1955;95(2):320-325. doi:10.1001/archinte.1955.00250080142011
Abstract

BECAUSE the Staphylococcus has the ability to develop resistance when exposed to currently used antibiotics, the treatment of staphylococcal disease, and particularly of endocarditis, is most difficult. A recent case well illustrates the emergence of a strain resistant to erythromycin. In vitro studies help to clarify the problem and show that resistant variants may appear from the great majority of staphylococcal strains.

The case described here is of interest from several other viewpoints. The causative organism was a coagulase-negative Staphylococcus albus. Infection was discovered following mitral valvotomy, a fairly rare occurrence,* despite the theoretic probability of such an event. The immediate cause of death seemed to be the occlusion of the mitral orifice by a large vegetation.

REPORT OF A CASE  B. B., a 52-year-old white housewife, reentered Stanford University Hospital on May 11, 1954, for mitral valvotomy. She had undergone rectal polypectomy and cryptectomy on April 7, 1954, without

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