Therapeutic Strategies for the Prevention of Rheumatic Fever

Editorials1 April 1977Therapeutic Strategies for the Prevention of Rheumatic FeverALAN L. BISNO, M.D., F.A.C.P.ALAN L. BISNO, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-86-4-494 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAcute pharyngitis is one of mankind's commonest maladies. Although it can have many etiologic agents (Corynebacterium diphtheriae, Mycoplasma pneumoniae, Neisseria gonorrhoeae, and others), in most cases the differential diagnosis comes down to viral or streptococcal infection. Both are likely to be benign and self-limited, although the latter can be associated with suppurative sequelae, such as acute sinusitis, otitis media, or peritonsillar abscess. The therapeutic implications are straight-forward: viral pharyngitis requires only supportive care, while patients with group A streptococcal sore throat should ordinarily receive penicillin therapy. Antibiotic therapy of "strep throat" is advocated both to prevent suppurative and, more important,...References1. WANNAMAKER L: Perplexity and precision in the diagnosis of streptococcal pharyngitis. Am J Dis Child 124:352-358, 1972 MedlineGoogle Scholar2. KAPLANTOPDUDDING LFB: Diagnosis of streptococcal pharyngitis: differentiation of active infection from the carrier state in the symptomatic child. J Infect Dis 123:490-501, 1971 CrossrefMedlineGoogle Scholar3. KAPLANBISNODERRICK EAW: American Heart Association Committee Report. Prevention of rheumatic fever. Circulation 55:S1-4, 1977 CrossrefMedlineGoogle Scholar4. TOMPKINSBURNESCABLE RDW: An analysis of the cost-effectiveness of pharyngitis management and acute rheumatic fever. Ann Intern Med 86:481-492, 1977 LinkGoogle Scholar5. FRANKSTOLLERMANMILLER PGL: Protection of a military population from rheumatic fever. Routine administration of benzathine penicillin G to healthy individuals. JAMA 193:775-783, 1965 CrossrefMedlineGoogle Scholar6. SIEGELJOHNSONSTOLLERMAN AEG: Controlled studies of streptococcal pharyngitis in a pediatric population. I. Factors related to the attack rate of rheumatic fever. N Engl J Med 265:559-566, 1961 CrossrefGoogle Scholar7. BISNOPEARCEWALL AIH: Contrasting epidemiology of acute rheumatic fever and acute glomerulonephritis. Nature of the antecedent streptococcal infection. N Engl J Med 283:561-565, 1970 CrossrefMedlineGoogle Scholar8. STOLLERMAN G: Rheumatogenic and nephritogenic streptococci. Circulation 43:915-921, 1971 CrossrefMedlineGoogle Scholar9. SCHWENTKER F: The epidemiology of rheumatic fever, in Rheumatic Fever, edited by THOMAS L. Minneapolis, University of Minnesota Press, 1952, pp. 17-27 Google Scholar10. SASLAWSTREITFELD MM: Group A beta hemolytic streptococci in relation to rheumatic fever. Study of school children in Miami, Fla. AMA J Dis Child 92:550-557, 1956 CrossrefMedlineGoogle Scholar11. BISNOPEARCESTOLLERMAN AIG: Streptococcal infections in rheumatic subjects without recurrences (abstract). Clin Res 23:415A, 1975 Google Scholar12. BELLSMITH SD: Quantitative throat-swab culture in the diagnosis of streptococcal pharyngitis in children. Lancet 2:61-63, 1976 CrossrefGoogle Scholar13. BREESEDISNEYTAPLEY BFW: Beta-hemolytic streptococcal infection. The clinical and epidemiologic importance of the number of organisms found in cultures. Am J Dis Child 119:18-26, 1970 CrossrefMedlineGoogle Scholar14. MILLERSTANCERMASSELL JSB: A controlled study of beta hemolytic streptococcal infection in rheumatic families. I. Streptococcal disease among healthy siblings. Am J Med 25:825-844, 1958 CrossrefMedlineGoogle Scholar15. GLEZENCLYDESENIOR WWR: Group A streptococci, mycoplasmas, and viruses associated with acute pharyngitis. JAMA 202:455-460, 1967 CrossrefMedlineGoogle Scholar16. ALPERTPICKERINGWARREN JMR: Failure to isolate streptococci from children under the age of 3 years with exudative tonsillitis. Pediatrics 38:663-666, 1966 MedlineGoogle Scholar17. KUTTNERKRUMWEIDE AE: Observations on the effect of streptococcal upper respiratory infections on rheumatic children: a three-year study. J Clin Invest 20:273-287, 1941 CrossrefMedlineGoogle Scholar18. POTTERSVARTMANPOON-KING EMT: Streptococcal infections antecedent to acute glomerulonephritis and acute rheumatic fever in Trinidad (abstract). Clin Res 23:533A, 1975 Google Scholar19. WIDDOWSONMAXTEDNOTLEY JWC: The antibody responses in man to infection with different serotypes of group-A streptococci. J Med Microbiol 7:483-496, 1974 CrossrefMedlineGoogle Scholar20. POLLYWALDMANHIGH SRP: Protective studies with a group A streptococcal M protein vaccine. II. Challenge of volunteers after local immunization in the upper respiratory tract. J Infect Dis 131:217-224, 1975 CrossrefMedlineGoogle Scholar21. BEACHEYCHIANGSEYER EEJ: Separation of the type-specific M-protein from toxic cross-reactive antigens of group A streptococci (abstract). Clin Res, in press, 1977 Google Scholar22. BEACHEYOFEK EI: Epithelial cell binding of group A streptococci by lipoteichoic acid on fimbriae denuded of M protein. J Exp Med 143:759-771, 1976 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Division of Infectious Diseases Department of Medicine University of Tennessee Memphis, Tennessee PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByGROUP A, GROUP C, AND GROUP G BETA-HEMOLYTIC STREPTOCOCCAL INFECTIONSQuantitation of group A beta-hemolytic streptococci in throat cultureL'analyse de la decision en pathologie infectieuse de l'enfantMicrobiologic StudiesCost-effective control of rheumatic fever in the communityEarly treatment of streptococcal pharyngitisStreptococcal Pharyngitis in a College Health PopulationTreating Sore Throats in the Emergency RoomDecision AnalysisPharyngeal gram stains in the treatment of sore throats 1 April 1977Volume 86, Issue 4Page: 494-496KeywordsHyperthermiaMycoplasma pneumoniaeNeisseria gonorrhoeaeOtitis mediaPenicillinPeritonsillar abscessesPharyngitisPharynxRheumatic feverStreptococcal infections Issue Published: 1 April 1977 PDF DownloadLoading ...