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May 5, 2021
Infective Endocarditis Hugo Schottmuller

Hugo Schottmuller (1867-1936)

Endocarditis lenta. Zugleich ein Beitrag zur Artunterscheidung der
pathogenen Streptokokken. Munch. med. Wschr., 1910, 57, 617-20, 697-99.

Hugo Schottmuller
Portrait of Hugo Schottmuller
Portrait of Hugo Schottmuller

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Hugo Schottmuller was a physician from Germany and reported his experience with chronic endocarditis that he called "Endocarditis lenta" in 1910. He was the first to isolate a specific type of cocci, streptococcus viridians, in that form of the affection.  In his manuscript, he stressed the importance of this specific bacterial agent in the etiology of chronic or subacute bacterial endocarditis.

During the same period, Rosenow and Libman were conducting similar studies in the United States and their research led to the isolation of the same type of microorganisms in subacute bacterial endocarditis. In his paper of 1910, Libman mentioned that he had isolated an "atypical non-hemolytic streptococcus" which was very slow to grow and was not very pathogenic in animal model. Libman in his manuscript wrote:

"Schottmuller in a recent publication, describes under the name "endocarditis lenta", the clinical features of subacute infective endocarditis. He cites 5 cases, in the blood of all of which he found the organism which he calls "Streptococcus mitior" or "Streptococcus viridians," because the colonies are those of a poorly growing organism and because they produce a green pigment on blood plates."

He then continued with a comment confirming Schottmuller's emphasis on the etiologic role of this agent:

"The important point to be brought out is that up to the present time whenever we have found the organisms which we have usually called endocarditis cocci par excellence (or attenuated streptococci of endocarditis) there was always present an infection of the endocardium. In no other disease have we found these organisms in the blood current. They, therefore, seem to have diagnostic import."

With significant advances in the techniques of culture and Gram staining, several researchers such as Schottmuller, Libman, and Rosenow contributed extensively to our microbiologic knowledge of the endocarditis. Their research enhanced our understanding of the etiologic role of these microorganisms in infective endocarditis.

The entire text of schottmuller's article is reproduced.

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Libman E, Celler LH.  The etiology of subacute infective endocarditis. Amer J med Sci 1910; 140:516-27.

Rosenow EC. Immunological and experimental studies on pneumococcus and staphylococcus endocarditis (chronic septic endocarditis). J Infect Dis 1909; 6:245-81


Sir William Osler George Baehr