RUPTURE OF SPLEEN IN SUBACUTE BACTERIAL ENDOCARDITIS

Abstract

THE ASSOCIATION of bacterial endocarditis and mycotic aneurysm has been recognized for over a century. In 1851, Koch¹described a patient with endocarditis who died suddenly after rupture of a superior mesenteric artery aneurysm. Tufnell²recognized the influence of emboli from valvular vegetations in the development of arterial aneurysms. Osler³termed these emboli "mycotic" and postulated the significant role of micro-organisms in the production of such aneurysms. In his Gulstonian Lecture on Malignant Endocarditis,⁴Osier described a case of "ulcerative endocarditis," with multiple small aneurysms involving the aortic arch. In 1887, Eppinger⁵demonstrated the actual infectious nature of the emboli, applying careful bacteriologic techniques. We are reporting a patient who recovered from subacute bacterial endocarditis complicated by a ruptured aneurysm of the splenic artery and rupture of the spleen. <h3>REPORT OF A CASE</h3> V. C., 401163, a 30-year-old white housewife, was admitted to the Research and Educational Hospital on March