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Robert L. McMillan, M.D.; E. Lloyd Wilbur, M.D.
JAMA. 1937;109(15):1194-1195. doi:10.1001/jama.1937.92780410003008b.
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Bacterial infection superimposed on syphilitic endocarditis is of interest because of the paucity of proved cases reported in the literature and the rarity of the infections occurring simultaneously, although each is common as a separate entity.

Kastner1 in 1918, Briggs2 in 1922, Pineles3 in 1926, and Craven4 in 1932 have each reported one case proved by autopsy. Other cases have been reported which have not been proved by autopsy but which presented aortic insufficiency, blood cultures positive for Streptococcus viridans and positive Wassermann reactions of the blood.

Cotton,5 in a study of fifty cases of aortic insufficiency, agrees with other authors that prior to the age of 40 rheumatic lesions predominate, whereas after 40 the lesions are almost entirely syphilitic or atherosclerotic. He corroborates the well known fact that bacterial endocarditis occurs as a rule in youth or young adulthood. Bayne-Jones6 has emphasized the increased vascularity of


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