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JAMA. 1930;95(11):808-809. doi:10.1001/jama.1930.02720110044020.
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ABSTRACT

Endocarditis Lenta  Professor Schupfer, director of the Clinica medica in Florence, recently delivered a lecture on endocarditis lenta at the Scuola di sanità militare. The speaker said that the disease is difficult to diagnose at the start and the patients are sent to the clinic under widely different diagnoses (malaria, cystopyelitis, undulant fever, renal tuberculosis). The clinical picture presents, indeed, a wide range of symptoms, although the endocarditis itself does not become manifest for some time. In the Florence clinic, Streptococcus viridans was isolated in 50 per cent of the patients with endocarditis lenta. That microorganism has the habit of implanting itself on previously injured valves of cardiopathic persons, so that if the patient had a mitral lesion it remains mitral and does not develop an aortic lesion, and likewise with other old valvular lesions. This fact differentiates clinically endocarditis lenta from other forms of endocarditis and is opposed to

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