Aortic valve endocarditis caused by Salmonella species

We report a case of aortic valve endocarditis caused by an uncommon pathoge n, Salmonella species. Transthoracic echocardiography proved to be inadequa te to show the valvular destruction. Transesophageal echocardiography was i nstrumental in establishing the diagnosis of endocarditis by documenting ao rtic vegetations with attendant tissue damage extending beyond the valve le aflets (ie, subvalvular and perivalvular damage). The findings were anatomi cally confirmed at surgery, which also revealed an aortic root-right ventri cular fistula and several aortic ring abscesses. Early implementation of tr ansesophageal echocardiography is strongly recommended in patients with sus pected endocarditis. (C) 1999 John Wiley & Sons, Inc.