A patient who died of Whipple's disease had moderate mitral stenosis with large firm yellow vegetations on the contact area of the mitral leaflets. Light microsocopy showed PAS positive macrophages within the thickened cusps and overlying vegetations. Negative images of rod-shaped bodies were visible in the cytoplasm of the histiocytes. No Aschoff bodies were seen, and there was no history of rheumatic fever. The findings in this patient lend support to the concept that chronic rheumatic type valvar deformity may result from a persistent intrinsic infectious agent.
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