Acute Bacterial Endocarditis
A 15 year old boy with cough and sputum developed a hectic fever and chest pain a few days before being admitted comatose. Examination revealed an early diastolic murmur at the aortic area which radiated down the left sternal edge. He had a rapid downhill course and died despite antibiotic chemotherapy. Blood cultures grew Staphylococcus aureus.
This small heart displays the left ventricle and associated valves. The non- coronary cusp of the aortic valve is ulcerated and perforated and has friable vegetations attached. Immediately below this cusp a perforation extends into the right atrium just above the tricuspid valve (see back of specimen). The other aortic cusp is thickened. This is an acute bacterial endocarditis with aortic cusp and atrioventricular perforations.