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Rheumatic fever in the 21st century.

G H Stollerman1

  • 1School of Medicine, Boston University, Boston, MA, USA. gstollerman@valley.net

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|August 21, 2001
PubMed
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Group A Streptococcus (GAS) causes acute rheumatic fever (ARF) and pharyngitis. Virulence factors like M protein and capsules distinguish ARF-causing strains from those causing common throat infections.

Area of Science:

  • Microbiology
  • Immunology
  • Infectious Diseases

Background:

  • Group A Streptococcus (GAS) is the established cause of acute rheumatic fever (ARF).
  • Strain virulence variation significantly impacts GAS-related diseases.

Observation:

  • Highly virulent GAS strains with large hyaluronate capsules and M proteins are linked to ARF pathogenesis.
  • Less virulent GAS strains cause common pharyngitis but colonize the throat persistently.
  • Distinct pyoderma strains cause glomerulonephritis but are not rheumatogenic.

Findings:

  • GAS virulence factors, including M protein epitopes and superantigens, are crucial in ARF development.
  • GAS pharyngitis remains prevalent, often caused by lower-virulence strains.
  • Specific GAS strains are associated with different clinical outcomes (ARF, pharyngitis, glomerulonephritis).

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Implications:

  • Understanding GAS virulence is key to preventing ARF.
  • Differentiating GAS strains is important for targeted treatment and prevention strategies.
  • Community prevalence of GAS strains influences ARF incidence.