Abstract
ABSTRACTInfective endocarditis can rarely present as a sudden or unexpected death occurring outside of hospital. Two such cases were studied and the diagnosis was determined only after autopsy examination. A 36-year-old male intravenous drug abuser had staphylococcal and enterococcal septicemia and endocarditis of the mitral valve. He died in jail five days after presenting with nausea and vomiting. The other case was an asymptomatic 30-year-old male with a bicuspid aortic valve and a coarctation of the aorta who developed Streptococcus viridans endocarditis and was found dead at home one hour after last being seen alive. Both had left ventricular failure from valve perforation and subsequent valve incompetence. The drug abuser had evidence of disseminated infection. Infective endocarditis was confirmed by appropriate histopathological examination and microbiological culture.
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