HEART - Bacterial Endocarditis

The heart appears enlarged. The tricuspid and mitral valves appear normal. On the ventricular surface of the aortic valve cusps there are large, pale vegetations. The material resting in one cusp is blood clot.
This 19-year-old Maori boy was admitted three weeks before death with bacterial endocarditis. Streptococcus viridans was isolated on blood culture. Severe aortic regurgitation developed, and he was considered for aortic valve replacement when he suffered a subarachnoid haemorrhage and died. No mycotic aneurysm was found in cerebral vessels at autopsy, although this is a likely cause for the subarachnoid haemorrhage. The normal underlying valves and fulminant course of illness in this case make the designation of acute bacterial endocarditis appropriate.