Pneumococcal Endocarditis, Meningitis, and Rupture of the Aortic Valve

Abstract

The advent of an effective prophylactic and therapeutic agent may alter significantly both the incidence and etiology of a given anatomical lesion, and such may be the effect of penicillin upon aortic valvular disease. As a result of its use in the treatment of early syphilis, syphilitic disease of the aortic valve is seen with lessening frequency, and it is altogether possible that the widespread employment of penicillin as a prophylactic against rheumatic fever may result in a decrease in aortic valvular disease of rheumatic origin. Concomitant with the decline of two of the major causes of aortic valvular disease, lesions of other etiologies will acquire relatively greater significance, and, paradoxically, antibiotics and notably penicillin can be responsible for the emergence of one of these. By preventing the premature death of patients with pneumococcal endocarditis, a hitherto almost uniformly fatal disorder, penicillin enables some of these persons to recover from