MITRAL VALVE –Bacterial endocarditis

The specimen is a mitral valve. The aperture has a characteristic "fish mouth" appearance. The valve leaflets are fused. Vegetations are present underlying the antero-lateral commissure, extending onto the chordae tendineae.
The patient was admitted with a history of diarrhoea and headaches. Blood cultures were positive for Streptococcus viridans and antibiotic therapy was commenced. Fever persisted for some time and echocardiography revealed involvement of the mitral valve. She underwent mitral valve replacement and made an uneventful recovery.