Browsing by Author "BLAZQUEZ, J"

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    ACUTE RHEUMATIC-FEVER AND POSTSTREPTOCOCCAL GLOMERULONEPHRITIS IN AN OPEN POPULATION - COMPARATIVE-STUDIES OF EPIDEMIOLOGY AND BACTERIOLOGY
    (1986) BERRIOS, X; QUESNEY, F; MORALES, A; BLAZQUEZ, J; LAGOMARSINO, E; BISNO, AL
    We conducted epidemiologic and bacteriologic studies of 104 cases of acute rheumatic fever (ARF) and 84 cases of poststreptococcal acute glomerulonephritis (AGN) occurring in the southeast health district of Santiago, Chile, between March 1978, and February 1982. The AGN cases were both postpharyngeal and postpyodermol in origin. Despite the fact tht ARF and AGN were occurring in the same neighborhoods and among families of equivalent size and socioeconomic status, the pharyngeal isolation rates of group A streptococci were significantly lower among patients with ARF and their household contacts than among patients with AGN and their contacts. Moreover, the streptococcal throat colonization rates and geometric mean anti-streptolysin O titers were similar in ARF families and the families of noninfected controls. Streptococci of M-type 5, a highly rheumatogenic type, were isolated from three patients with ARF (representing 36% of group A isolates from this group) and one ARF contact but never from patients with AGN, control subjects, or their respective contacts. These observations suggest possible differences in the streptococcal milieus from which ARF and AGN cases emerge. The nature of such differences requires further exploration.
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    ARE ALL RECURRENCES OF PURE SYDENHAM CHOREA TRUE RECURRENCES OF ACUTE RHEUMATIC-FEVER
    (1985) BERRIOS, X; QUESNEY, F; MORALES, A; BLAZQUEZ, J; BISNO, AL
    We are conducting prospective studies of patients in Santiago, Chile, who have had an attack of rheumatic fever and are receiving continuous secondary prophylaxis with monthly injections of benzathine penicillin G. Throat cultures are obtained just prior to injection each month, and serum antistreptococcal antibody titers (antistreptolysin O and antideoxyribonuclease B) are performed at least every 3 months. During the course of these studies we have observed 17 recurrences of "pure" chorea in 10 patients (six girls). In four recurrences the timing of serologic studies and onset of chorea appeared to exclude the occurrence of an immunologically significant group A streptococcal infection within the preceding 6 to 9 months. In one case the period of serologic follow-up was too brief to allow a definite determination. In the remaining 12 recurrences serologic evidence was suggestive or confirmatory of recent streptococcal infection; however, in several instances the titer elevations were quite modest. Our data suggest that in certain chorea-prone patients. Sydenham chorea may recur after streptococcal infections too weak and transient to be readily detectable or, alternatively, after stimuli other than streptococcal infection.