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Steinmann has studied 350 cases of scarlet fever clinically, roentgenologically and electrocardiographically. He has come to the conclusion expressed by students of scarlet fever everywhere, that myocarditis can often be demonstrated in this disease. Myocardial disturbance has been specifically pointed out by Toomey as being a concomitant feature of the disease. The author makes the distinction between early minor and late cardiac involvements—late as seen in the second to fourth week of the disease, often in older children. This distinction is not clearcut, probably being merely relative. Steinmann produced myocardial disturbances experimentally in rabbits by injecting Dick toxin. He feels that there is a difference between scarlatinal and rheumatic carditis, a difference which is not admitted by all students of the disease. Many of the American workers believe that all these conditions are late results of streptococcicoses in the sense described by Powers of Yale.
Das Herz beim Scharlach.. Am J Dis Child. 1947;73(4):529. doi:10.1001/archpedi.1947.02020390141011