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
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Diseases presenting "heart disease" symptom

22q11.2 deletion syndrome

achondroplasia

acute rheumatic fever

adrenal incidentaloma

child syndrome

classical phenylketonuria

cohen syndrome

congenital diaphragmatic hernia

dentinogenesis imperfecta

esophageal adenocarcinoma

fabry disease

familial mediterranean fever

heparin-induced thrombocytopenia

hirschsprung disease

holt-oram syndrome

homocystinuria without methylmalonic aciduria

kabuki syndrome

monosomy 21

omenn syndrome

phenylketonuria

sneddon syndrome

systemic capillary leak syndrome

wiskott-aldrich syndrome

wolf-hirschhorn syndrome

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