The study of streptococcal infections and their sequelae has in the last two decades yielded several important findings on the biological properties of cellular and extracellular products of group A streptococci. These findings have contributed to a better knowledge of the pathological reactions occurring in the macroorganism during host-parasite interactions. Nevertheless, the pathogenesis of streptococcal infections is not fully understood. So far there has been no success in eliciting experimentally, either through the action of the substances isolated from the cell, or from broth culture filtrate of group A streptococci, symptoms that are fully identical with any type of acute streptococcal infection. It also has not been possible to explain the mUltiplicity of clinical and histological changes caused by streptococci as being due solely to anyone of these substances or a combination thereof. The same applies to the sequelae of streptococcal infections, rheumatic fever and acute glomerulonephritis. We do not know how the group A strepto coccus elicits these diseases and we have only a partial understanding of the pathological processes, initiated by this streptococcus, and resulting in cardiac or renal lesions. It is clear that an organism infected by streptococci is exposed to the action of a complex of substances. A more detailed recognition of the biological activity of the single components and their combination under defined experimental conditions may be capable, it is hoped, to explain the pathologic processes triggered in the course. of the development of group A streptococcal infection.
