We enjoyed reading Wahl's recent review article1 on dental-induced endocarditis. His clarification of the facts about this disease was very useful.
We wish to report a case of endocarditis associated with use of a home plaque removal instrument to illustrate several of his points.
Report of a Case.
A 62-year-old man, with previously proven mitral valve prolapse and mitral regurgitation, presented to his family physician with a 10-week history of not feeling well. In the week prior to presentation, he developed fever, chills, anorexia, and pain in the fingertips of one hand.On examination, the patient was pale, with toxic effects, and had an oral temperature of 38.2°C. Cardiac examination revealed a pulse rate of 88 beats per minute, a blood pressure level of 120/76 mm Hg, and a grade III/VI holosystolic murmur in the mitral area, with no systolic click. The heart rhythm was normal sinus, and there