Gram-negative organisms are a rare cause of infective endocarditis. Escherichia coli, the most common cause of urinary tract infection and gram-negative septicemia involves endocardium rarely. In this case report, we describe infection of native mitral valve by E. coli following septicemia of urinary tract origin in a diabetic male; subsequently, he required prosthetic tissue valve replacement indicated by persistent sepsis and congestive cardiac failure.

A case of infection with Corynebacterium ulcerans (C. ulcerans), resulted in the sudden death of a previously healthy 73-year-old woman. Death from Corynebacteriwm diphtheriae (C. diphtheriae) infection is well-documented. Fatalities following infection with C. ulcerans are unreported: this would appear to be the Erst documented death due to such infection.

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The question of measuring blood cholesterol values for assessing risk in individuals will continue to be debated. What is certain is that blood cholesterol concentrations in British men are high and constitute a considerable risk for ischaemic heart disease. The high risk approach in the United States and Great Britain would appear to have severe limitations. Given the present distribution of blood cholesterol concentrations in British men, nothing short of a population approach is likely to be effective, and even that would have to be applied from childhood if it is to have much effect.