Studies concerning the significance of Streptococcus hemolyticus in scarlet fever.

Abstract

The more or less constant presence of Streptococcus hemolyticus in the throats of individuals suffering from scarlet fever has been generally recognized for many years. This organism is also the preponderant causative agent of such septic complications of the disease as otitis media, adenitis, interstital nephritis, arthritis, and septicemia. Such widespread and general relationship of streptococcus to scarlet fever naturally gave rise to the view, supported by a number of investigators, that streptococcus might be the etiological agent of the disease. Belief in the validity of this conception led to the preparation and trial of antistreptococcic sera for therapeutic purposes. For some of these efficacious results have been claimed. On the other hand another group of investigators has asserted that streptococcus bears only a secondary relationship to scarlet fever and cannot be assigned the principal causative role. Discussion of this question was carried on for many years and became part of the larger controversy concerning the nature of the whole group of organisms generically designated as S. hemolyticus. The balance was finally tipped against the etiological importance of S. hemolyticus by Jochmann, who claimed that it is unreasonable to suppose that a specific disease such as scarlet fever can be caused by an organism giving rise to such varied manifestations as S. hemolyticus and furthermore that the presence of this organism cannot be demonstrated in certain rapidly fatal malignant instances of the diseases.