Coxsackie virus and rheumatic fever. A correlative study

Twenty-one patients of whom 13 had acute rheumatic fever and 8 had recurrence of rheumatic fever were studied for the evidence of coxsackie B viral infection using neutralisation test. A significant rise was noted in 17 cases (81%) and two cases had very high initial titre of neutralising antibodies to coxsackie B viruses type 1 to 6. Mixed infection with more than one serotype was seen in 11 cases. Coxsackie B2 was the commonest type and 14 patients had antistreptolysin 'O' anti-bodies. The high incidence of coxsackie B viral infection in rheumatic fever and the coexistent streptococcal infection and their relationship are discussed.