Although there is a consensus about the responsibility of betahemolytic streptococcus in the rheumatic fever (RF) etiology, in this article the author claims that persist doubts about a possible concomitant viral condition. This paper also reviews the streptococcus structures and stresses the fact that each outbreak of the disease is produced by a different streptococcus serotype. Concerning the pathogenesis, the author discusses three different mechanisms: a) slow bacterial action, b) the action produced by toxins and c) hypersensitivity reactions. Finally, the author also emphasizes the recent discovery of a B cell antigen called D 8/17.
rheumatic fever (RF); beta-hemolytic streptococcus; antistreptolysin O; M protein; HLA-DR7; D/8 17; rheumatic carditis; rheumatic chorea