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October 1, 1967

Escherichia coli Endocarditis: A Review of the Literature and a Case Study

Arch Intern Med. 1967;120(4):472-477. doi:10.1001/archinte.1967.04410010086012

ALTHOUGH the methods of therapy for bacterial endocarditis due to viridans streptococci have been well established, optimal therapy for endocarditis resulting from gram-negative organisms is much less well studied. This report describes the successful management of a patient with a fulminant Escherichia coli endocarditis, reviews the related literature, and discusses the therapeutic program.

Report of a Case  A 52-year-old diabetic woman was admitted to University Hospitals on May 11, 1966, with a two-week history of progressive dysuria, frequency, and urgency, culminating in shaking chills, high-spiking fever, and left flank pain the night prior to admission. On the day of admission she was treated elsewhere with orally administered penicillin and sodium bicarbonate for a presumed urinary tract infection.Medical history was pertinent in that she had acute rheumatic fever at age 22, with a subsequent episode of acute cardiac decompensation during pregnancy, necessitating a therapeutic abortion. The murmurs of mitral stenosis,