We studied the clinical and anatomic features in 14 habitual alcoholics who had infective endocarditis. Alcoholism is frequently associated with fatal infective endocarditis. When infective endocarditis develops in alcoholics, the causative organism is usually Diplococcus pneumoniae (10 of 14 patients). The endocarditis, however, is usually not the most prominent clinical feature of their illness. Acute pneumonia (11 patients) and acute meningitis (nine patients) overshadows the endocarditis. Often, alcoholism is part of the tetrad of pneumococcal endocarditis, pneumonitis, meningitis, and chronic alcoholism.
Buchbinder NA, Roberts WC. Alcoholism: An Important but Unemphasized Factor Predisposing to Infective Endocarditis. Arch Intern Med. 1973;132(5):689–692. doi:10.1001/archinte.1973.03650110045009
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