Streptococcal Agglutinins in Rheumatic Fever.

Although considerable evidence has accumulated that rheumatic fever is a streptococcal infection, attempts to demonstrate specific streptococcal agglutinins in the serums of patients with tWis disease have met with only a moderate degree of success. Tunnicliff (1) performed agglutination reactions with the serums of twelve rheumatic fever patients against strains of Micrococcus rheumaticus and Streptococcus pyogenes, and demonstrated agglutinins in small amounts in seven instances. Swift and Kinsella (2) failed to find any streptococcal agglutinins in the serums of five patients with rheumatic fever against streptococci which they had recovered from their respective blood cultures. Clawson (3) working with strains of Streptococcus viridans isolated from cases of rheumatic fever, found agglutinins in four out of the five serums examined. Small (4) demonstrated agglutinins for the so-called "streptococcus cardioarthritidis" in the serums of ten patients with rheumatic fever. In a previous paper the writers, in collaboration with Cecil (5), have reported the isolation of streptococci from the blood and joints of a high percentage of patients with rheumatic fever. These strains, with one exception, belonged to the general group of non-hemolytic streptococci.2 Cross agglutination and absorption tests performed with immune rabbit serums indicated that while these streptococci