Coburn1 called attention to the changes occurring from one year to another in the clinical manifestations of the rheumatic state. More striking, even, are the modifications through which the clinical concept of the rheumatic state has passed in recent years; and it has seemed to us of some interest to review the records of our youngest group of rheumatic patients, in the hope of obtaining a picture of the clinical and anatomic manifestations of the disease at an early age. We had the impression that rheumatic fever expresses itself in a subject under 3 years of age in a manner different from that by which one is accustomed to recognize it in older children. At the same time, its infrequency in early life throws a formidable obstacle in the path of the individual observer who attempts to formulate from his own experience a not too one-sided picture of the
McINTOSH R, WOOD CL. RHEUMATIC INFECTIONS OCCURRING IN THE FIRST THREE YEARS OF LIFE. Am J Dis Child. 1935;49(4):835–848. doi:10.1001/archpedi.1935.01970040003001
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