“Acute rheumatic fever is proceeded by an infection with Group A strep” is a mantra that all health care workers know. This episode digs through the history of how we came to understand this fact, as well as how our understanding of the pathophysiology and treatment of rheumatic fever developed. Intro :10 Why I made this episode :30 Outline of this episode 1:55 Rheumatic fever was really bad 3:10 The early 1700s 4:10 A big leap 6:15 The Jones criteria 11:07 History of the bacteriology 14:23 The heroic ASO titre 20:51 Rheuminations is powered by Healio 21:40 Another breakthrough: penicillin 21:51 Not all group A strep is the same 25:06 The decline of rheumatic fever 25:56 What about the host? 29:30 The joints 38:56 Summary 40:28 Never appreciated how bad rheumatic fever was 42:18 We’d love to hear from you! Send your comments/questions to rheuminationspodcast@healio.com. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum References: A History of Medical Bacteriology and Immunology, First Edition, Butterworth-Heinemann, Oxford, 1970. Aspinall GO, et al. Infect Immun. 1994;62:2122-2125. Carapetis JR, et al. Nat Rev Dis Primer. 2016;doi:10.1038/nrdp.2015.84. Cox CJ, et al. J Immunol. 2013;doi:10.4049/jimmunol.1102592. Engel ME, et al. PLoS One. 2011;6:e25326. FW Denny, et al. JAMA. 1950;143:151-153. Gray LA, et al. J Infect Dis. 2017;216:1460-1470. Kaplan MH, et al. Lancet. 1962;1:706-710. Karthikeyan G, Guilherme L. Lancet. 2018;392:161-174. Khandke KM, et al. J Exp Med. 1987;doi:10.1084/jem.166.1.151. Paul O, et al. Clin Cardiol. 1990;13:367-369. Quinn A, et al. Infect Immun. 2001;69:4072-4078. Robertson KA, et al. BMC Cardiovasc Disord. 2005;5:11. Rojas Manuel, et al. J Autoimmun; 2018;95:100-123. Tandon R, et al. Nat Rev Cardiol. 2013;10:171-177.