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ENTEROCOCCAL ENDOCARDITIS

THOMAS N. JAMES, M.D.
AMA Arch Intern Med. 1952;90(5):646-652. doi:10.1001/archinte.1952.00240110072007.
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ONLY since bacterial endocarditis has become a treatable disease has its precise etiological classification assumed clinical importance. Although use of penicillin has reduced cases of the refractory disease to a minority, little headway has been made with this small group. It has become apparent that many penicillin-resistant cases are due to one of the enterococci.1

What fraction of these is caused by such organisms, streptococci of Lancefield Group D, is difficult to state, for until very recently most blood cultures have not been routinely investigated far enough to assure whether a yielded organism was an Enterococcus or not. Of greatest significance in this regard are the hemolytic properties of these bacteria: They may be alpha, beta, or gamma hemolytic, most commonly the last. Thus, when an alpha hemolytic Streptococcus has been isolated, identification has seldom been pressed further, a serious omission with a resistant organism.

Bacteriological characteristics of the

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