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HEMOLYTIC STREPTOCOCCIC SORE THROAT:  The Poststreptococcic State

LOWELL A. RANTZ, M.D.; PAUL J. BOISVERT, M.D.; WESLEY W. SPINK, M.D.
Arch Intern Med (Chic). 1947;79(4):401-435. doi:10.1001/archinte.1947.00220100051004.
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IT HAS been known for more than thirty years that recovery from hemolytic streptococcic infection of the respiratory tract is frequently complicated by the development during convalescence of a variety of disorders including fever, arthritis, carditis and nephritis.1 These conditions are clearly not the result of a direct invasion of the remote tissues by streptococci present in the throat during the initial illness and may be regarded as "late nonsuppurative complications"2 of hemolytic streptococcic disease. The importance of this concept has been emphasized by the increasing body of evidence which indicates that rheumatic fever is one of the late complications of infection by hemolytic streptococci. Recent investigation has greatly increased the information available in regard to the bacteriology, immunology and natural history of streptococcic infection and its complications. In a series of papers3 the pertinent literature has been reviewed, and the clinical manifestations of the intial phase

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