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Adolph Sachs, M.D.; Sven Isacson, M.D.
JAMA. 1937;108(20):1706-1707. doi:10.1001/jama.1937.92780200003007b.
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Subacute bacterial endocarditis is a moderately common occurrence in most larger clinics. Libman has presented this syndrome so clearly to the profession that the diagnosis in most cases is readily made. The Libman facies, the clubbing of the fingers, the chills, fever and sweats, the enlarged spleen, the showers of infarcts, the petechiae, the positive blood culture, the history of an old valvular endocarditis, the moderately prolonged illness and the usual fatal ending are so characteristic that the profession is constantly alert to recognize its occurrence; but subacute or acute bacterial endocarditis involving only the right chambers of the heart is not common, and the profession at large should be awakened to this syndrome so that more cases will be recognized.

The right sided subacute bacterial endocarditis usually is found in old congenital heart lesions, but it may also occur without a recognizable congenital lesion. The symptoms of right sided


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