A patient who has an existing heart condition has dental surgery but neglects to inform her dentist of this disorder.She later develops endocarditis as a consequence of the procedure.Which of the following organisms most likely caused endocarditis?

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The primary causes of infective endocarditis are the viridans streptococci,made up of several species (Box 67-2).These organisms are normal inhabitants of the oral cavity,often gaining entrance to the bloodstream as a result of gingivitis,periodontitis,or dental manipulation.Heart valves,especially those previously damaged,present convenient surfaces for attachment of these bacteria.Streptococcus sanguinis and S.mutans are frequently isolated in streptococcal endocarditis.

A Patient Who Has an Existing Heart Condition Has Dental