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March 1946

NONSUPPURATIVE POSTSTREPTOCOCCIC (RHEUMATIC) PNEUMONITIS: Pathologic Anatomy and Clinical Differentiation from Primary Atypical Pneumonia

Arch Intern Med (Chic). 1946;77(3):237-253. doi:10.1001/archinte.1946.00210380002001

CLINICAL recognition of pulmonary lesions in rheumatic fever is increasing. Many careful descriptions of the pathologic anatomy of rheumatic pneumonitis, obtained from cases in which death was due to rheumatic carditis, have finally brought into focus what seems to be a highly characteristic picture, gross and microscopic, now generally familiar to pathologists. Pathologic details may not be so familiar to most clinicians. It is not yet possible, however, to identify the disease solely on the basis of a single anatomic change in the lungs alone—to recognize any one feature as pathognomonic. This is due somewhat to the fact that rheumatic fever is always a disease of many organs, and when only a part of the picture is viewed either clinically or anatomically in one organ at a time it seems to blend with other conditions, usually regarded as separate diseases.

So far as this concerns the pulmonary lesion, the pathologic