rheumatic fever

Question 1

what is rheumatic fever?

Answer 1

an inflammatory infection that starts at the throat by Group A B-Haemolytic Streptococci that is triggered after 2-4 weeks.

It is a streptococci pyogenes infection.

It is also a systemic infection
-> affects the connective tissue around the body; especially in the heart, joints, brain and skin.

Question 2

what is the peak incidence?

Answer 2

5 and 15 years old

In some cases, rheumatic fever causes long-term damage to the heart and its valves
-> rheumatic heart disease.

Question 3

what are 7 symptoms?

Answer 3

Fever

Arthralgia (pain in joints)

Arthritis (pain and inflammation of joints)

Carditis (inflammation of the heart and surroundings)

Erythema Marginatum (Red rash)

Sydenham’s Chorea (involuntary, semi-purposeful movements)

Subcutaneous Nodules

Question 4

what do you use to diagnose it?

Answer 4

Revised Jones Criteria (there must be evidence of recent Streptococcus infection plus 2 Major criteria, or 1 Major and 2 Minor criteria)

Question 5

what is the management?

Answer 5

Bed Rest (until CRP is normal, for two weeks, and possibly up to three months)

Aspirin 100mg/kg/d is divided doses over two days, then 70mg/day/d for six weeks

Question 6

what is the secondary prophylaxis?

Answer 6

Secondary Prophylaxis:

Penicillin V 250mg/12h PO (5-year prophylaxis is sufficient unless they have carditis in which you would do 10-year prophylaxis, but if they have carditis AND persistent valvular disease then continue prophylaxis until 40y/o)