The aortic valve was described as bicuspid at autopsy but there seems to be remnants of a third
cusp present. The valve cusps have been largely destroyed by vegetations which were described
as partly calcified. There is a small nodule of similar material in relation to one coronary ostium.
This child was transferred from Tonga at the age of 14 with bacterial endocarditis; there
was a history of shortness of breath on exertion, weight loss, and mumps one week before
admission. No organisms were recovered. At autopsy the mitral valve was also involved and death
was due to pneumonia. The severe destruction of the valve cusps by the vegetations and the
fulminant course of the illness make the designation acute bacterial endocarditis appropriate.