Filtrates From Scarlet Fever and Surgical Hemolytic Streptococcus Infections.

Abstract

In scarlet fever it is held that there is a special strain of hemolytic streptococcus responsible for scarlet fever. Nevertheless, by agglutination tests, all strains isolated from cases of scarlet fever are not identical. It has not been argued that a special phase of reactivity on the part of the host can lead to the clinical picture of scarlet fever after infection by any hemolytic streptococcus.

The criteria for investigating the specific nature of a given strain of hemolytic streptococcus, whether from scarlet fever or from other clinical infections, have been the preparation of a filtrate from special culture medium and the testing of such filtrate for its resistance to heating, its capacity to produce a dermal reaction in a susceptible subject, and its neutralization by anti-scarlet fever serum in skin tests.

The following would indicate either that these criteria are not sufficient to establish the specific qualities of a given strain, or that the phase of reactivity of a patient is important in determining whether infection by hemolytic streptococcus will result in scarlet fever or some other clinical picture. The filtrates were studied from the throat cultures of three cases of scarlet fever, two of which were caused by infection of wounds; and of three cases of bacteriemia following operations, in one of which the attending nurse developed scarlet fever.

In the three cases of scarlet fever the cultures from the throat failed to yield hemolytic streptococcus. In two of these cases, one of which was surgical scarlet and the other the usual variety, the predominating organisms were non-hemolytic streptococcus which were immediately used to infect filtrate broth. Subcultures of this broth failed to show any colonies of hemolytic streptococcus on blood agar plates.