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October 1, 1967

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

Author Affiliations

Madison, Wis

From the departments of medicine and pediatrics, University of Wisconsin School of Medicine, the State Laboratory of Hygiene, and the John A. Hartford Research Laboratory, Madison General Hospital, Madison, Wis. Dr. Cherry is now at the Department of Pediatrics, St. Louis University School of Medicine, St. Louis.

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,