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Early rheumatic infections of childhood
533
ABSTRACTS
A consideration of these cases and of other simiposition as recovery occurred. lar cases reported in the literature points to the fact that this phenomenon is not infrequent in childhood and would in all probability be more often noted if specially looked for by physical examination and if radiograms of the chest were taken early. Displacement of the heart appears to be brought about by the traction exercised by shrinkage due to partial collapse of the affected lung, aided by the push of the sound lung which is frequently distended by compensatory emphysema. This cardiac displacement is it occurs in the acute stage of its normal position. Moreover, tion can evidence of fibrosis be
McLean,
C. C.:
Early
not caused by a pulling over due to fibrosis, since the disease and the heart subsequently returns to neither by physical nor by radiological examinanoted.
Rheumatic
Infections
of Childhood.
Arch.
Ped.
46:
657.
1929. The author reports 118 eases of early rheumatic infection seen in private prac tice in Birmingham, Alabama, during the past eight years. There were 51 boys and 6i girls included in the study. The age of greatest frequency was from five to eight years. The most common symptoms presented by the patients when first seen were poor appetite, failure to gain weight, nervousness, fatigue, repeated attacks of tonsillitis and nasopharyngeal infection, and pain in the legs, joints or stiffness of limbs. Forty-four children had tonsils and adenoids rcmoved when the diagnosis of rheumatic infection was made but most of thest: cases gave a history of repeated attacks of tonsillitis and suggestive symptoms of a rheumatic infection before the operation. There were signs and symptoms of mild chorea in 42 of the children. Of the 118 cases 84, or 71 per cent, had soft blowing systolic murmurs. These murmurs were heard in 52.3 per cent of the chorea patients and in 81.5 per cent of the 76 who had no signs of ehorea. Apparently there was little or no hypertrophy of the heart. Of 35 of infection cases which sinuses,
the 118 children there were 103 underweight for their height. There wero the 118 cases who developed symptoms and physical signs of rheumatic while under observation. Many of these children were original foeding who had been under care throughout their lives. There were 92 cases in the foci of infection was thought to have been located in tonsils, teeth, ears, or nasopharyngeal tissue.
The author describes of these children. He Several case reports are
in brief stresses included.
In conclusion, he believes that rheumatic infection is a potential cordingly.
the rest
management in bed and
every child with cardiac patient
instituted removal
in of
manifestations and should
Coates, Vincent: The Relation of Orthodox Rheumatic Infective Arthritis. Brit. M. .J. 1: 67, 1930.
the foci
be
Infection
care of each of infection. of an managed
early ac.
to Multiple
By orthodox rheumatic infection the author means frank rheumatic fevrr am1 by multiple infective arthritis he means that type of subacute or chronic arthritis which is nonsuppurative and is due to an infection of a nonspecific character. He has studied the possible relationship between these two conditions by the following methods: 1. The evidence afforded by the family history of fifty consecutive eases of multiple infective arthritis in regard to orthodox rheumatic infection. In 16 instances rheumatic fever was known to have occurred in a parent, brother or
ABSTRACTS
A consideration of these cases and of other simiposition as recovery occurred. lar cases reported in the literature points to the fact that this phenomenon is not infrequent in childhood and would in all probability be more often noted if specially looked for by physical examination and if radiograms of the chest were taken early. Displacement of the heart appears to be brought about by the traction exercised by shrinkage due to partial collapse of the affected lung, aided by the push of the sound lung which is frequently distended by compensatory emphysema. This cardiac displacement is it occurs in the acute stage of its normal position. Moreover, tion can evidence of fibrosis be
McLean,
C. C.:
Early
not caused by a pulling over due to fibrosis, since the disease and the heart subsequently returns to neither by physical nor by radiological examinanoted.
Rheumatic
Infections
of Childhood.
Arch.
Ped.
46:
657.
1929. The author reports 118 eases of early rheumatic infection seen in private prac tice in Birmingham, Alabama, during the past eight years. There were 51 boys and 6i girls included in the study. The age of greatest frequency was from five to eight years. The most common symptoms presented by the patients when first seen were poor appetite, failure to gain weight, nervousness, fatigue, repeated attacks of tonsillitis and nasopharyngeal infection, and pain in the legs, joints or stiffness of limbs. Forty-four children had tonsils and adenoids rcmoved when the diagnosis of rheumatic infection was made but most of thest: cases gave a history of repeated attacks of tonsillitis and suggestive symptoms of a rheumatic infection before the operation. There were signs and symptoms of mild chorea in 42 of the children. Of the 118 cases 84, or 71 per cent, had soft blowing systolic murmurs. These murmurs were heard in 52.3 per cent of the chorea patients and in 81.5 per cent of the 76 who had no signs of ehorea. Apparently there was little or no hypertrophy of the heart. Of 35 of infection cases which sinuses,
the 118 children there were 103 underweight for their height. There wero the 118 cases who developed symptoms and physical signs of rheumatic while under observation. Many of these children were original foeding who had been under care throughout their lives. There were 92 cases in the foci of infection was thought to have been located in tonsils, teeth, ears, or nasopharyngeal tissue.
The author describes of these children. He Several case reports are
in brief stresses included.
In conclusion, he believes that rheumatic infection is a potential cordingly.
the rest
management in bed and
every child with cardiac patient
instituted removal
in of
manifestations and should
Coates, Vincent: The Relation of Orthodox Rheumatic Infective Arthritis. Brit. M. .J. 1: 67, 1930.
the foci
be
Infection
care of each of infection. of an managed
early ac.
to Multiple
By orthodox rheumatic infection the author means frank rheumatic fevrr am1 by multiple infective arthritis he means that type of subacute or chronic arthritis which is nonsuppurative and is due to an infection of a nonspecific character. He has studied the possible relationship between these two conditions by the following methods: 1. The evidence afforded by the family history of fifty consecutive eases of multiple infective arthritis in regard to orthodox rheumatic infection. In 16 instances rheumatic fever was known to have occurred in a parent, brother or