QUANTITATIVE ANTISTREPTOKINASE STUDIES IN PATIENTS INFECTED WITH GROUP A HEMOLYTIC STREPTOCOCCI: A COMPARISON WITH SERUM ANTISTREPTOLYSIN AND GAMMA GLOBULIN LEVELS WITH SPECIAL REFERENCE TO THE OCCURRENCE OF RHEUMATIC FEVER 1

Abstract

Bacteriologic and serologic studies were made on 90 young males who acquired scarlet fever during a single epidemic. From all one or more types of group A hemolytic streptococci were isolated. Antistreptokinase (antifibrinolysin) and antistrep-tolysin O were the antibodies studied. Gamma globulin levels were detd. on each serum using Kunkel''s turbidimetric technique. The presence of more than one type of streptococcus during an infection seemed to evoke a greater antibody and gamma globulin response than did the presence of only a single type. Penicillin therapy which effectively removed the infecting organism from the nasopharynx either prevented entirely or greatly reduced the expected antibody response. Penicillin did not seem to diminish the total antibody response as measured by the gamma globulin. Those patients who developed rheumatic fever after scarlet fever did not exhibit an antistreptokinase response which differed in pattern from that of the antistreptolysin O or the gamma globulin response. On the average those patients who developed rheumatic fever exhibited a greater specific antibody response and a greater increase in gamma globulin than those who did not develop rheumatic fever.