CEREBRAL MANIFESTATIONS OF BACTERIAL ENDOCARDITIS

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Abstract
A review has been made of 35 cases of Bacterial Endocarditis admitted to the Hospital Division of the Medical College of Virginia over a period of 5 years. Lesions of C.N.S. occurred in 17 (48.5%) and 9 (25%) were admitted to the hospital primarily as neurological, neurosurgical or mental cases. The fundamental C.N.S. lesion is a diffuse meningo-encephalitis due to multiple emboli both infected and sterile. Clinically meningitis occurred most frequently with the acute infection and hemiplegia with the subacute. Subarachnoid hemorrhage, intrayentricular hemorrhage, ependymitis, aphonia, stupour, irrational speech and action, headache and dizziness occurred as clinical and pathologic features of the disease. In no case was Streptococcus viridans isolated from the spinal fluid. Any "sterile" meningitis should always be investigated for the presence of a subacute endocarditis. The cases of acute bacterial endocarditis often occurred without signs of valvular heart disease.

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