Pleural involvement in rheumatic fever is an important episode in the course of the disease. Lesions may result from some complication, such as myocardial failure or pulmonary infarction, or may be due to the disease itself, as are the more common involvements of the synovia, myocardium, endocardium and pericardium. Fifteen cases of rheumatic fever in which there was undisputed evidence of pleural involvement have been studied. For purposes of discussion we have divided them into two groups: (1) thirteen cases of true rheumatic pleurisy and (2) two cases of bilateral hydrothorax accompanying myocardial failure.
FIBRINOUS PLEURISY
Case 1.
—A girl, 15 years of age, was admitted to the hospital, complaining of a sharp pain in the left axilla, which was increased in severity on inspiration. Six years and three years previously she had had rheumatic fever. Twelve days before admission, following recovery from a mild cold in the head, she