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Article
March 1956

Subacute Bacterial Endocarditis: Splenectomy in Cases Refractory to Antibiotic Therapy

Author Affiliations

Indianapolis

From the Departments of Pathology (Drs. Lingeman and Smith), Surgery (Dr. Battersby), and Medicine (Dr. Behnke) of the Indiana University School of Medicine and the Indiana University Medical Center.

AMA Arch Intern Med. 1956;97(3):309-314. doi:10.1001/archinte.1956.00250210055004
Abstract

With the use of modern antibiotic therapy, 60% to 70% of patients with subacute bacterial endocarditis are cured. Formerly at least 97% of cases were fatal.1 Even if penicillin or other antibiotics are temporarily successful in sterilizing infected heart valves, a "focus" of infection in any organ of the body may "shower" bacteria into the blood to prevent permanent cure.

The literature contains few reports of cases in which removal of the spleen, the site of an infected infarct or abscess, resulted in cure of the disease. Riesman,2 in 1918, suggested that the spleen might serve as a "focus" of infection in certain cases of subacute bacterial endocarditis. Polowe,3 in 1939 reported a case of subacute bacterial endocarditis in which a 20-month cure followed splenectomy; in his survey of the literature prior to that year, he found 15 fatal cases of this disease recorded in which splenectomy had been performed.

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