That the meningococcus may be responsible for extrameningeal lesions and that these lesions need not necessarily be associated with infection of the meninges has been known for some years.
Probably the first case recorded in which this organism was demonstrated as the cause of endocarditis was reported by Warfield and Walker1 in 1903. A negro, aged 32, was admitted to the hospital in a delirious condition, having been ill for a period of two weeks with headaches, chills, fever and delirium. The patient had an herpetic eruption of the lips, a systolic murmer at the apex, irregular heart action, with 11,000 leukocytes, and a temperature of 103 F. During his hospital stay, the patient continued to have chills and a septic temperature. The course continued progressively downward and he died one month after admission. Autopsy showed an acute ulcerative endocarditis, mitral stenosis, infarcts in the spleen and kidneys, and