THE EFFECT OF TONSILLECTOMY ON THE INCIDENCE OF STREPTOCOCCAL RESPIRATORY DISEASE AND ITS COMPLICATIONS

PEDIATRICS ◽  
1960 ◽  
Vol 26 (3) ◽  
pp. 355-367
Author(s):  
Robert Chamovitz ◽  
Charles H. Rammelkamp ◽  
Lewis W. Wannamaker ◽  
Floyd W. Denny
Keyword(s):  
Heart Disease ◽  
Respiratory Tract ◽  
Antibiotic Therapy ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Streptococcal Infection ◽  
Clinical Course ◽  
Respiratory Infections ◽  
Acute Illness ◽  
Streptococcal Infections

A population of military men with acute streptococcal respiratory infections (diagnosis established by clinical, bacteriologic and serologic studies) was investigated. Evidence is presented indicating that individuals who have had a tonsillectomy are neither more nor less susceptible to acute streptococcal infections of the respiratory tract. Once individuals acquire a streptococcal infection, the clinical course of the acute illness is not modified appreciably by the presence or absence of the tonsils. However, if antibiotic therapy is withheld, suppurative complications occur less frequently in those patients who have had their tonsils removed. Tonsillectomy did not alter significantly the attack rate of acute rheumatic fever as a sequel of streptococcal infections, nor did it reduce significantly the development of valvular heart disease in patients with acute rheumatic fever. Moreover, it appears that streptococcal infections are less readily recognized in tonsillectomized patients and, therefore, are more likely to escape treatment appropriate for the prevention of rheumatic fever.

URINARY EXCRETION OF COPROPORPHYRIN BY CHILDREN DURING AND AFTER ACUTE STREPTOCOCCAL INFECTIONS

PEDIATRICS ◽  
1958 ◽  
Vol 21 (5) ◽  
pp. 722-730
Author(s):  
John T. Galambos
Keyword(s):  
Urinary Excretion ◽  
Rhode Island ◽  
Scarlet Fever ◽  
Acute Rheumatic Fever ◽  
Streptococcal Infection ◽  
Streptococcal Pharyngitis ◽  
Acute Illness ◽  
Streptococcal Infections ◽  
Group Iii ◽  
Group I

The 24-hour urinary excretion of coproporphyrin was measured in three groups of children. Group I consisted of 88 children with acute scarlet fever, hospitalized in Providence, Rhode Island, during an epidemic in the spring of 1957. Single 24-hour specimens of urine were obtained during the first or second week of illness. Group II was composed of 54 children with sporadic streptococcal pharyngitis seen by private pediatricians in Atlanta, Georgia. Urinary excretions of coproporphyrin were measured during the acute illness and at weekly intervals thereafter. Group III included 21 children with nonstreptococcal pharyngitis. Acute streptococcal infection usually is not associated with a significantly increased rate of urinary excretion of coproporphyrin in children who do not develop subsequent acute rheumatic fever. A greater rate of urinary excretion of coproporphyrin by boys than by girls was significant at the 1% level of confidence.

EVALUATION OF THE STREPTOCOCCAL DESOXYRIBO-NUCLEASE B AND DIPHOSPHOPYRIDINE NUCLEOTIDASE ANTIBODY TESTS IN ACUTE RHEUMATIC FEVER AND ACUTE GLOMERULONEPHRITIS

PEDIATRICS ◽  
1962 ◽  
Vol 29 (4) ◽  
pp. 527-538
Author(s):  
Elia M. Ayoub ◽  
Lewis W. Wannamaker
Keyword(s):  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Streptococcal Infection ◽  
Acute Glomerulonephritis ◽  
Streptococcal Infections ◽  
Antibody Titers ◽  
Streptococcal Antigens ◽  
Anti Body ◽  
Antibody Tests ◽  
Normal Controls

Antibody titers for two recently described streptococcal antigens, desoxyribonuclease B (DNase B) and diphosphopyridine nucleotidase (DPNase) have been compared with antistreptolysin O (ASO) titers in patients with acute rheumatic fever, in patients with acute nephritis, and in normal controls. Like the ASO, elevated titers for the two new antibodies are commonly found in patients with complications of streptococcal infections. The titers for anti-DPNase tend to be higher in acute nephritis than in acute rheumatic fever. These two new anti-body tests are particularly useful in providing evidence of a preceding streptococcal infection in those patients with manifestations of acute rheumatic fever or acute nephritis who fail to show an elevated ASO titer.

EFFECT OF AUREOMYCIN TREATMENT OF STREPTOCOCCAL SORE THROAT ON THE STREPTOCOCCAL CARRIER STATE, THE IMMUNOLOGIC RESPONSE OF THE HOST, AND THE INCIDENCE OF ACUTE RHEUMATIC FEVER

PEDIATRICS ◽  
1953 ◽  
Vol 12 (6) ◽  
pp. 593-606
Author(s):  
HAROLD B. HOUSER ◽  
GEORGE C. ECKHARDT ◽  
EDWARD O. HAHN ◽  
FLOYD W. DENNY ◽  
LEWIS W. WANNAMAKER ◽  
...  
Keyword(s):  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Streptococcal Infection ◽  
Treated Group ◽  
Carrier State ◽  
Control Group ◽  
Streptococcal Infections ◽  
Drug Of Choice ◽  
Penicillin Therapy ◽  
Treatment Data

A total of 1,009 patients with exudative tonsillitis or pharyngitis, predominantly streptococcal in etiology, was treated with aureomycin hydrochloride. A control group of 1,035 patients received no aureomycin. An illness classified as definite or possible rheumatic fever subsequently developed in 20 patients who had received aureomycin and in 29 who had received no treatment. Data collected on rheumatic subjects indicated that when the interval between the onset of the observed attack of exudative tonsillitis or pharyngitis and the onset of rheumatic fever exceeded 35 days, an intervening streptococcal infection had occurred. Five patients in the treated group and 20 in the control group developed rheumatic fever within a 35 day interval. These data indicated that aureomycin therapy greatly reduces the subsequent occurrence of rheumatic fever. Aureomycin therapy was also found to eradicate the streptococcus from the oropharynx in a large number of instances and to inhibit the formation of antistreptolysin. The degree of inhibition of antistreptolysin formation was shown to correlate with the eradication of the streptococci from the oropharynx. When bacteriologic relapse occurred following cessation of aureomycin therapy, the degree of inhibition of antistreptolysin production was low. Aureomycin therapy of streptococcal infections was compared to penicillin therapy of such infections. It was shown that penicillin was more effective in eradicating streptococci, decreasing antistreptolysin formation, and preventing rheumatic fever. Penicillin, therefore, is the drug of choice.

Epidemiology and global burden of rheumatic heart disease

ESC CardioMed ◽  
2018 ◽  
pp. 314-322
Author(s):  
Dianne Sika-Paotonu ◽  
Andrea Beaton ◽  
Jonathan Carapetis
Keyword(s):  
Heart Disease ◽  
Rheumatic Fever ◽  
Rheumatic Heart Disease ◽  
Acute Rheumatic Fever ◽  
Indigenous Populations ◽  
Autoimmune Response ◽  
Global Burden ◽  
Streptococcal Infections ◽  
Group A ◽  
Rheumatic Heart

Acute rheumatic fever is caused by the body’s autoimmune response to a group A streptococcal infection, classically pharyngitis. Rheumatic heart disease refers to the long-term cardiac damage caused by either a single severe episode or multiple recurrent episodes of acute rheumatic fever. It is rheumatic heart disease that remains a significant worldwide cause of morbidity and mortality, particularly in resource-poor settings. Improved living conditions and widespread treatment of superficial group A streptococcal infections have meant acute rheumatic fever/rheumatic heart disease are now rare in developed countries although some Indigenous populations living in wealthy nations are adversely affected. Acute rheumatic fever largely affects children between the ages of 5–14 years with risk factors for acute rheumatic fever/rheumatic heart disease including age, sex, environmental influences that increase exposure to group A streptococcal infections, and host susceptibility. Since rheumatic heart disease results from cumulative damage, the peak prevalence of clinically symptomatic rheumatic heart disease occurs between the ages of 20–40 years. Conservative estimates indicate between 275,000 and 345,000 deaths occur each year from rheumatic heart disease with global burden of disease figures in 2013 calculating at least 32.9 million prevalent rheumatic heart disease cases. In 2015, rheumatic heart disease was ranked as the 43rd leading cause of years of life lost and is attributed to an annual 1.8 million years lived with disability and 9 million lost disability-adjusted life years. More than 75% of the world’s children are currently living in countries where rheumatic heart disease remains endemic. Effective rheumatic heart disease prevention, control, and management warrants prioritization if World Health Organization global targets to reduce premature deaths from cardiovascular diseases by 25% by 2025 are to be achieved.

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