To the Editor.
—The article by Cooke et al in the Archives (1979;139:1247-1250) prompted me to write concerning two recent blood culture-documented cases of Neisseria gonorrhoeae endocarditis at Brooke Army Medical Center (BAMC). The patients fulfilled many of the clinical criteria mentioned by Cooke and co-workers. Both were younger than 30 years, with a negative history of previous venereal disease. Neither patient had preexisting heart disease, and both had aortic valve involvement. Unfortunately, both of the patients died.I noticed, as did Cooke and co-workers, the low and delayed yield from blood cultures. One patient had three of 14 cultures postive, with a delay of four days for the first to become positive. The other patient had two of ten positive, with a five-day delay. In an effort to determine why the yield from blood cultures was poor even with endocarditis, the following study was done.Three standard 50-mL blood