Subacute endocarditis

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Subacute endocarditis (also called endocarditis lenta) is a type of endocarditis (more specifically, infective endocarditis) usually caused by a form of streptococci bacteria that normally live in the mouth and throat (Streptococcus mutans, mitis, sanguis,or milleri). Other strains of streptococci (bovis and equines) can also cause subacute endocarditis, usually in patients who have a form of gastrointestinal cancer.

Underlying structural valve disease is usually present in patients before developing subacute endocarditis. It is less likely to lead to septic emboli than is acute endocarditis, but subacute endocarditis has a relatively slow process of infection and, if left untreated, can worsen for up to one year before it is fatal.


The standard treatment is with a minimum of four weeks of high-dose intravenous penicillin with an aminoglycoside such as gentamicin.


Verhagen DWM, Vedder AC, Speelman P, van der Meer JTM (2006). "Antimicrobial treatment of infective endocarditis caused by viridans sterptococci highly susceptible to penicillin: historical overview and future considerations". J Antimicrob Chemother. 57: 819&ndash, 24. doi:10.1093/jac/dk1087.