THE OCCURRENCE OF ANTIFIBRINOLYTIC PROPERTIES IN THE BLOOD OF PATIENTS WITH ACUTE HEMOLYTIC STREPTOCOCCUS INFECTIONS

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Abstract
A specific antisubstance directed against the fibrin-dissolving action of hemolytic streptococci was demonstrable in the blood of ca. 75% of patients who recovered from acute streptococcus infections. The fibrin clot from the blood of patients who died of the infection was in no case capable of inhibiting the bacterial fibrinolytic action. The antifibrinolytic response was demonstrable at the approximate time of recovery in some patients and in others was not detected until the 2d-4th wk. in convalescence. With some exceptions, the specific response appeared during the course of erysipelas earlier than following acute streptococcus infections of the upper respiratory tract. Of 28 patients who developed antifibrinolytic resistance, all recovered completely, and no reactivation of the streptococcus infection interrupted their convalescence. In 7 of 17 patients who failed to acquire humoral antifibrinolytic properties, the disease was self-limiting and convalescence was uneventful; of the remaining 10, 7 died and 3 had prolonged illnesses due to exacerbations of active streptococcus infection. In the few cases of active rheumatic fever and acute nephritis studied, antifibrinolytic resistance was usually present, and did not differ in development from that in cases of acute streptococcus infection without the visceral affections of rheumatic fever or acute nephritis.