Rheumatic Fever and Rheumatic Heart Disease (The Stigmas of Sore Throat)

Abstract

The prevention of acute rheumatic fever by penicillin therapy of acute streptococcal respiratory infections was attempted in this study. Procaine penicillin G in oil containing 2 per cent aluminum monostearate was injected intramuscularly according to one of three dosage schedules in 1,178 patients with exudative tonsillitis or pharyngitis while 1,162 patients remained untreated and served as controls.

There was a total of ten patients who had received penicillin and forty-two patients who received no treatment in whom an illness classified as definite or possible rheumatic fever subsequently developed.

Data collected on rheumatic subjects showed that reinfection with a new type of streptococcus frequently occurred when the interval between the onset of the observed attack of exudative tonsillitis or pharyngitis and the onset of rheumatic fever was prolonged. Excluding those cases of rheumatic fever developing after a forty-five-day interval between the two diseases results in two cases of rheumatic fever in the treated group and twenty-eight in the control patients. These data indicate that penicillin therapy of acute streptococcal infections almost completely prevents the subsequent occurrence of acute rheumatic fever.