Production of Generalized Shwartzman Reaction with Group A Streptococcal Factors.

Abstract

A soluble factor from group A streptococcal skin lesions prepared American Dutch rabbits for the generalized Shwartzman reaction. The reaction could be provoked in rabbits prepared with this material not only by toxins from Gram-negative organisms but also by reduced filtrates of streptococcal cultures with a high streptolysin O content. This adds significance to the possible role of this reaction in the pathogenesis of the nonsuppurative sequelae associated with group A streptococcal infections. The tissue changes associated with the reaction brought about with these materials include myocardial necrosis and cortical necrosis of the kidney. Although these reactions simulate those observed in the classical generalized Shwartzman reaction, the following differences were noted: a generalized rather than a local reaction was developed upon preparation of rabbits with the streptococcal factor, death was a more prominent feature than is usually observed in the generalized Shwartzman reaction, and the time interval between the 2 injns. could be reduced to a shorter period than is possible in the classical reaction. It was possible to immunize rabbits against the preparative activity of the soluble factor by repeated injns. of the streptococcal skin lesion extract.