A patient who has an existing heart condition has dental surgery but neglects to inform her dentist of this disorder. She later develops endocarditis as a consequence of the procedure. Which of the following organisms most likely caused endocarditis?
a. Escherichia coli
b. Staphylococcus aureus
c. Streptococcus mutans
d. Pseudomonas aeruginosa
C
The primary causes of infective endocarditis are the viridans streptococci, made up of several species (Box 67-2). These organisms are normal inhabitants of the oral cavity, often gaining en-trance to the bloodstream as a result of gingivitis, periodontitis, or dental manipulation. Heart valves, especially those previously damaged, present convenient surfaces for attachment of these bacteria. Streptococcus sanguinis and S. mutans are frequently isolated in streptococcal endocar-ditis.
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