Infective endocarditis caused by Streptococcus mutans. A complication of idiopathic hypertrophic subaortic stenosis
N. Robbins, G. Szilagyi, H. B. Tanowitz, S. Luftschein and S. G. Baum
Three patients with endocarditis caused by Streptococcus mutans were seen
during a six-month period. All had clinical features of subacute bacterial
endocarditis, including fever, heart murmurs, and positive blood cultures.
One had underlying aortic insufficiency and two had idiopathic hypertrophic
subaortic stenosis. All patients were treated with parenteral antibiotics
and were cured. Streptococcus mutans is a pleomorphic, microaerophilic
organism that is associated with dental caries and plaque. Differentiation
of S mutans from enterococcal endocarditis is important because the former
condition can be treated for a shorter period of time with penicillin
alone, without the addition of aminoglycoside antibiotics.