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To the Editor: In reading the study of S aureus endocarditis by Dr Fowler and colleagues,¹ I was struck by a possible discrepancy in the figures relating S viridans to antecedent dental procedures. Table 1 indicated that of 1779 patients with endocarditis, 558 cases were due to S aureus, while many other pathogens were isolated from the remaining 1221 patients. This included 319 patients with viridans group streptococci, about 18% of the study population. However, Table 2 shows dental procedures listed for only 127 patients (10.4%) with non–S aureus endocarditis and 18 patients (3.2%) with S aureus. Together they total 145, only 8.2% of the entire study population.

My question concerns the 174 patients who would be needed to supplement these 145 to achieve the 319 with viridans group streptococci. It appears that S viridans, an oral bacterium, was found in many patients with nondentally related endocarditis. . . . [Full Text of this Article]

Mortimer Lorber, DMD, MD
melorber@aol.com
Department of Physiology and Biophysics
Georgetown University School of Medicine
Washington, DC

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