Acute Vegetative Endocarditis Caused by Bacillus Diphtheriae

Acute vegetative endocarditis caused by the diphtheria bacillus is of infrequent occurrence, the literature up to the present time containing reports of only six cases. The micro-organisms isolated in three of these cases had all the cultural and morphologic characteristics of Bacillus diphtheriae but did not produce a toxin in amounts sufficient to be lethal for guinea-pigs. In the other three cases reported the bacilli were characteristic of B. diphtheriae morphologically and culturally as well as in their lethal effect when broth cultures were injected into guinea-pigs. The nontoxic bacilli simulating B. diphtheriae were isolated at autopsy in the cases reported by Howard1in 1893 and by Roosen-Runge2in 1903 and 1925. Herzog3in 1918 was the first to isolate a strain of B. diphtheriae from the blood in pure culture which was lethal for guinea-pigs when 1 cc. of a three day broth culture was inoculated