- immune system biology
- signs and symptoms
- investigations
- conditions and diseases
- treatments
Section Links
Rheumatic Fever
- causes and risk factors
- signs and symptoms
- diagnosis
- pathophysiology
- treatments
- consequences and course
- patient education
- community resources
- references
Causes and Risk Factors
RF is an acute multisystem inflammatory disease occurring a few weeks after an episode of group A streptococcal pharyngitis.
Incidence and mortality have decreases dramatically over the past decades, owing to improved socioeconomic conditions, rapid diagnosis and treatment, and an unexplained decrease in virulence. However, in developing countries, and in low-income urban areas of the West, rheumatic fever remains an important public health concern.
Signs and Symptoms
Symptoms occur 2-3 weeks after infection .
Migratory polyarthritis of the large joints, carditis, subcutaneous nodules, erythema marginatum of the skin , and Sydenham chorea...
sync this with GAS.
Acute rheumatic carditis can be followed by chronic disease.
Diagnosis
Pathophysiology
RF does not follow strep infections in the skin.
It is strongly suspected pharyhgitis induces a hypersensitivity reaction. Cross reactivity with the M proteins of certain bacteria and glycoproteins of the heart, joints, and other tissues appears to occur.
Treatments
Prophylaxis
Prophylaxis is given up to adolescence.
AHA 2007 guidelines have altered when prophylaxis is given, suggesting that:
only receive prophylaxis for dental procedunres if (oral amoxicillin first choice):
- prosthetic valves
- previous endocarditis
- 3 types of congenital heart disease
- cardiac transplant
Consequences and Course
Heart
The most important consequences are chronic valvular deformities, characterized principally by fibrotic disease, especially of the mitral valve. This can lead to serious, even fatal cardiac problems decades later.
Patient Education
Community Resources