THE ANALYSIS OF STREPTOCOCCAL INFECTIONS

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Abstract
The rapid death which occurred after intravenous injection of activated streptolysin O from Group A or group C streptococci was always preceded by profound ecg alterations. After several multiples of the LD50 doses, cardiac electrical arrest or fibrillation could occur within 2 to 4 seconds after completion of the injection. Smaller lethal doses caused a variety of ecg changes, which usually terminated within several minutes in cardiac standstill. They often involved T wave, S-T segment, and conduction disturbances. Similar changes were seen with non-lethal doses. The streptolysin O preparations used were rather highly purified. Evidence that the observed results were due to streptolysin O was also obtained by tests with the reversibly oxidized materials, and by cholesterol inactivation. Four non-streptolysin containing streptococcal antigens and Shigella para-dysenteriae endotoxin failed to produce striking ecg abnormalities. A working hypothesis has been developed implicating streptolysin O as the etiological streptococcal factor responsible for the pathogenesis of rheumatic fever, which seems to account for the principal features of this illness.

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