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Sarva Rickhi
Anjanie MaharajH
ViviOn Bissoon
Definition
Rheumatic fever is a systemic
inflammatory disease affecting the
peri-arteriolar connective tissues and
can occur after an untreated Group A
Beta haemolytic streptococcal
pharyngeal infection.
ETIOLOGY
Etiology
• 2/3 with acute rheumatic fever have
Hx of an URTI several weeks before.
• Peak age and seasonal incidence of
acute rheumatic fever closely
parallel those of GAS infections
• Patients with rheumatic fever almost
always have serologic evidence of a
recent GAS infection
•
Etiology (cont’d)
Chorea
Diagnosis (cont’d)
• Diagnosis of RF can be established
by the Jones criteria when a patient
fulfills
– 2 Major Criteria (and meets the
absolute requirement) OR
– 1 Major Criteria and 2 Minor Criteria
(and meets the absolute
requirement)
• Even with strict application of Jones
Criteria, overdiagnosis as well as
underdiagnosis may occur
Diagnosis (cont’d)
Less joint pain (relative to other More joint pain (relative to other
clinical findings) clinical findings)
• Penicillin/Erythromycin
– Oral
– 10 days
OR
• Benzathine Penicillin
– Single IM injection
NOTE:
Antibiotic therapy does NOT alter the
§ Supportive therapy
– Digoxin
– Fluid and salt restriction
– Diuretics eg. ACE inhibitors
– Oxygen
Termination of Anti-
Inflammatory Therapy
• May result in a rebound of clinical
manifestations and laboratory
abnormalities
•
• Usually resolve spontaneously
•
• If severe symptoms- hospitalisation
and reinstitution of salicylates or
steroids as necessary
vSydenham’s Chorea
§ Considered to be a benign self
limiting disease
§ Usually requires no therapy
2001.
Diseases
Immunology: