Streptococci causing IE are most commonly a group of species called viridans group streptococci. The most common of this group are Streptococcus salivarius, Streptococcus mutans, Streptococcus mitus, and Streptococcus sanguis. This group of bacteria, considered normal flora in the human mouth, is «-hemolytic, and typically, most clinical microbiology laboratories do not differentiate the exact species. These organisms may cause bacteremia after dental procedures, which can lead to the development of IE in at-risk patients. Viridans group streptococci are also the predominant pathogen of IE associated with mitral valve prolapse and native valves and in children.19,20 Another streptococci species that is commonly associated with IE is Streptococcus bovis, classified as group D streptococci, found in the GI tract. However, owing to the similarities of these streptococci, including microbiologic susceptibility, treatment is similar regardless of the species.

Table 74-2 Modified Duke's Criteria for IE

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