Rheumatic fever

General or Other | Cardiology | Rheumatic fever (Disease)


Description

Rheumatic fever is an inflammatory disease that may develop as a complication of a streptococcus infection, such as strep throat or scarlet fever (caused by Streptococcus pyogenes or group A beta-hemolytic streptococcus). If it does not develop, it will usually do so two to three weeks after the Group A streptococcal infection.

Causes and Risk factors

Rheumatic fever is common worldwide and is responsible for many cases of damaged heart valves.

Rheumatic fever can occur at any age but primarily affects children from 5 years old to 15 years old.

Diagnosis and Treatment

In addition to previous infection with streptococcus (i. e. positive throat culture, rising ASO titer), the diagnosis of rheumatic fever requires the presence of 2 major Jones criteria or 1 major plus 2 minor Jones criteria.

Major Jones criteria include: carditis, polyarthritis (arthritis in two or more joints), chorea, erythema marginatum (skin rash), subcutaneous nodules. Minor Jones criteria include: arthralgia, fever, previous rheumatic fever or rheumatic heart disease, laboratory findings including elevated erythrocyte sedimentation rate, elevated C-reactive protein, elevated white blood cell count, prolonged PR interval on an electrocardiogram (EKG) (a pause in the electrical activity).

Treatment of acute rheumatic fever is geared toward the reduction of inflammation with anti-inflammatory medications such as aspirin or corticosteroids. Individuals with positive cultures for strep throat should also be treated with antibiotics. nother important cornerstone in treating rheumatic fever includes the continual use of low-dose antibiotics (such as penicillin, sulfadiazine, or erythromycin) to prevent recurrence. ...