The Clinical Importance of Infection of the Respiratory Tract in Rheumatic Fever

The clinical association of infections of the upper respiratory tract with the precipitation of attacks of rheumatic fever has received attention for many years. More recently, the reports of Coburn and his co-workers¹have stressed the importance of the invasion of the respiratory tract by the hemolytic streptococcus in infections of the upper respiratory tract associated with rheumatic fever. This relation between hemolytic streptococcus tonsillitis or pharyngitis and recurrent rheumatic fever is familiar to the majority of the students of the disease. On the other hand, Wilson and her co-workers²state that, "while the occurrence of respiratory infections in a rheumatic child may not be a fortuitous event, it would seem to bear no more specific etiological relationship to rheumatic disease than would be attributed to similar episodes occurring in the tuberculous child." The data to be discussed are the clinical portion of the results of a large