CLINICAL OBSERVATIONS ON THE EVENTS PRECEDING THE APPEARANCE OF RHEUMATIC FEVER 12

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Abstract
Recurrent rheumatic fever following respiratory infection has been noted frequently in recent literature. In an effort to detn. the importance of such infection in precipitating rheumatic fever, the authors present cases in which the disease has been observed subsequent to other infections, accidents, and operative procedures. Further, intraven. injection (single or once repeated) of typhoid-paratyphoid vaccine was given in 10 selected cases in which the patients had laboratory evidence, but little clinical evidence, of rheumatic fever; in 6 cases, recurrent rheumatic fever occurred either immediately following the vaccine reaction or within 3 or 4 wks. There appeared to be no significant clinical difference between the recurrences or recrudescences of rheumatic fever following (1) respiratory infection, (2) other forms of infection, (3) accidents or operative procedures, and (4) a single intraven. injection of typhoid-paratyphoid vaccine. These observations suggest that incidents preceding rheumatic fever may be non-specific.

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