Description
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.
History
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.