The likely cause of infective endocarditis in which streptococcus viridans is involved is

The likely cause of infective endocarditis in which streptococcus viridans is involved is

• A. Following a dental procedure
• B. Pancarditis of rheumatic fever
• C. Congenitally Bicuspid aortic valve
• D. IV drug use

Answer: (A)

Viridans group streptococci are normal inhabitants of the oral cavity, and they cause endocarditis most often after transient bacteremia from dental work or dental disease. Their virulence is relatively low, so infection tends to be subacute and typically involves a valve that is already damaged or abnormal. This makes dental procedures a classic precipitating event for endocarditis caused by these organisms. By contrast, rheumatic pancarditis is immune-mediated rather than infection-driven by oral flora; a congenitally bicuspid aortic valve is a risk factor for endocarditis in general but does not specify the oral source; and intravenous drug use is more commonly linked to Staphylococcus aureus causing acute endocarditis on the right heart.

Viridans group streptococci are normal inhabitants of the oral cavity, and they cause endocarditis most often after transient bacteremia from dental work or dental disease. Their virulence is relatively low, so infection tends to be subacute and typically involves a valve that is already damaged or abnormal. This makes dental procedures a classic precipitating event for endocarditis caused by these organisms. By contrast, rheumatic pancarditis is immune-mediated rather than infection-driven by oral flora; a congenitally bicuspid aortic valve is a risk factor for endocarditis in general but does not specify the oral source; and intravenous drug use is more commonly linked to Staphylococcus aureus causing acute endocarditis on the right heart.