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The management of subacute bacterial endocarditis superimposed on rheumatic heart disease in the immediate pre-penicillin era: the case of Pasquale Imperato.
[acute rheumatic fever]
Subacute
bacterial
endocarditis
(
SBE
)
was
invariably
a
fatal
disease
in
the
pre-penicillin
era
.
The
availability
of
sulfonamide
antibiotics
beginning
in
the
mid-
1930
s
raised
hopes
that
they
would
be
effective
in
SBE
.
Unfortunately
,
except
in
rare
instances
,
they
were
not
.
This
paper
reviews
the
clinical
experience
with
sulfonamides
in
the
pre-penicillin
period
in
treating
patients
with
SBE
.
It
presents
in
detail
the
case
of
Pasquale
Imperato
,
who
died
from
the
disease
at
the
age
of
72
years
on
30
November
1942
.
In
so
doing
,
it
focuses
on
the
medical
management
measures
then
available
to
treat
patients
with
SBE
and
on
the
inevitable
course
of
the
illness
once
it
began
.
Also
discussed
is
the
relationship
of
acute
rheumatic
fever
and
its
sequela
,
rheumatic
heart
disease
,
to
predisposing
people
to
SBE
and
possible
genetic
factors
.
The
well-known
case
of
Alfred
S
.
Reinhart
,
a
Harvard
Medical
School
student
who
died
from
SBE
in
1931
and
who
kept
a
detailed
chronicle
of
his
disease
,
is
also
discussed
and
contrasted
with
Pasquale
Imperato
's
case
.
Diseases
Validation
Diseases presenting
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated