Acute bacterial endarteritis.

Abnormality of a valve predisposes to bacterial endocarditis, even when mechanical beating action is absent, as in destruction of a cusp by previous rheumatic disease. Yet the formation of vegetations at sites other than valvular endocardium is rare; and, in spite of the frequency and apparent suitability of aortic ulcers, no report of bacterial endarteritis upon simple atheroma has been found in the list of aortic diseases in the Index Medicus covering the last ten years. However, Sherf and Boyd (1948) say that, in rare cases, acute bacterial endarteritis develops on the basis of syphilitic aortitis or of atheroma. White (1945) points out that the aortic intima may be involved in the endocarditis and that ulceration of the valve, the heart wall, or the wall of the aorta is common in more severe cases. He does not mention an acute endarteritis as occurring in the absence of an endocarditis. Neither do Libman and Friedberg (1941) mention this possibility.