The incidence of pneumococcal endocarditis (PE) has decreased from 15% to 20% of all cases of endocarditis in the preantibiotic era to less than 5% after the introduction of penicillin.1,2 Several case series have underscored the aggressive course of PE, with acute clinical presentation, rapid valvular destruction, and high mortality despite appropriate antibiotic therapy.1-6 Pneumococcal prosthetic valve endocarditis (PPVE) has been rarely reported. In a literature survey in which we used MEDLINE files dating back to 1965, we found only 3 cases reported in detail.5,7,8 Two additional cases have been mentioned in series of PE.2,6 Finally, there were 2 other cases, reported 25 years ago in a series involving prosthetic valve endocarditis, in which this complication developed shortly after valve replacement.9 Herein, we present a case of PPVE and review the previously reported cases.
Report of a Case.
A 61-year-old woman presented with high fever,