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Ann Intern Med. 1944;21(3):494-496. doi:10.7326/0003-4819-21-3-494
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Although it has long been known that rheumatic fever is a generalized infection in which many tissues and organs may be involved, the frequent occurrence of disseminated vascular lesions in this disease has not been so generally appreciated. Krehl1 is generally credited as the first clearly to describe such lesions in the myocardium of patients with rheumatic valvular disease. His observations have been amply confirmed and the character of the lesions described, particularly by Karsner and Bayless and in great detail by Gross, Kugel and Epstein.2 The latter observed outspoken endarteritis in one-third of their active cases.

Such lesions, however,


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