Abstract Approximately 2,500 cases of systemic meningococcal infections are reported to the National Center for Disease Control in Atlanta each year. Meningococcal endocarditis (ME) is, however, a quite rare disease with a total of 24 cases cited in the last published review in 1946.1 To our knowledge, there has been no prior report of Neisseria meningitidis which involved an artifical valve prosthesis. The unusual fulminant course associated with this organism and the potential chance of antibiotic control stimulated this patient report. Patient Summary A 58-year-old white woman was admitted for the third time to Rush-Presbyterian-St. Luke's Medical Center on March 23, 1969, because of increasing weakness and easy fatigability. She had developed rheumatic fever when she was a child and had three recurrent acute attacks of rheumatic fever before she was 28 years old. She did well until three years prior to admission when she developed progressive dyspnea on exertion, References 1. Firestone GM: Meningococcus endocarditis. Amer J Med Sci 211:556-564, 1946.Crossref 2. Braimbrige MV: Cardiac surgery and bacterial endocarditis. Lancet 1:1307-1309, 1969.Crossref 3. Block PC, De Sanctis RW, Weinberg AN, et al: Prosthetic valve endocarditis. J Thorac Cardiovasc Surg 60:540-548, 1970. 4. Clark H, Pattin RD: Post cardiotomy endocarditis due to Neisseria perflava on a prosthetic aortic valve. Ann Intern Med 68:386-387, 1968.Crossref 5. Cecil RC, Soper WB: Meningococcus endocarditis with septicemia: Its bearing on the mode of infection in epidemic cerebrospinal meningitis. Arch Intern Med 8:1-16, 1911.Crossref 6. Krumbhaar EB, Cloud JH: Acute meningococci endocarditis and septicemia. JAMA 71:2144-2146, 1918.Crossref 7. Rhoads CP: Vegetative endocarditis due to the meningococcus. Clin J Path 3:623-629, 1927. 8. Hylands CM: Meningococcus endocarditis. JAMA 92:1412, 1929.Crossref 9. Gwyn NB: Subacute meningococcal endocarditis. Arch Intern Med 48:1110-1117, 1931.Crossref 10. Master AM: Meningococcus with endocarditis. JAMA 96:164-166, 1931.Crossref 11. MacMahon HE, Burkhardt EA: Meningococcal endocarditis. Amer J Path 5:197-213,1929. 12. Williams MG: Meningococcal endocarditis and myocarditis. Amer J Path 16:365-374, 1940. 13. Appelbaum E: Chronic Meningococcus septicemia. Amer J Med Sci 193:96-108, 1937.Crossref 14. Carbonell A, Campbell EP: Prolonged meningococcemia: Report of three cases. Arch Intern Med 61:646-654, 1938.Crossref 15. Nye RB, Smisch CW, Merves L: Chronic meningococcemia complicated by acute endocarditis. Ann Intern Med 16:1245-1252, 1942.Crossref 16. Benoit FL: Chronic Meningococcemia. Amer J Med 35:103-112, 1963.Crossref 17. Beeson PB, Westerman E: Cerebrospinal fever. Brit Med J 1:497-500,1943.Crossref 18. Banks HS: Meningococcosis: A protean disease. Lancet 2:677-681, 1948.Crossref 19. Nelson KE, Levin S, Lepper MH, et al: Bacterial meningitis: A review of 1,073 cases, abstracted. Ann Intern Med 72:798, 1970.Crossref 20. Levin S, Painter MB: The treatment of actue meningococcal infections in adults: A reappraisal. Ann Intern Med 64:1049-1056, 1966.Crossref 21. Denmark TC, Knight EL: Cardiovascular and coagulation complications of group C meningococcal disease. Arch Intern Med 127:238-240, 1971.Crossref 22. Hardman JM, Earle KM: Myocarditis in 200 fatal meningococcal infections. Arch Path 87:318, 1969.
Archives of Internal Medicine – American Medical Association
Published: Jun 1, 1972