Case 224. Meningococcal endocarditis (27 y-o F)
    Autopsied heart with large verruca formation in the thickened mitral valve in case of meningococcal meningitis    
Key words : Neisseria meningitidis, endocarditis, septicemia
Verruca is attached to the thickened mitral valve. Pre-existing rheumatic valvular disease is indicated by shortening of chorda tendinae and dilated left atrium (gross findings).   Colonies of lightly basophilic cocci are clustered in the mitral valve showing hyaline fibrosis (HE).
The coccal colonies are Gram-negative, and are consistent with Neisseria meningitidis (Gram). Refer to case 98.