Rheumatic Fever

Question 1

How does rheumatic fever present?

Answer 1

sore, swollen joints (polyarthritis)
restless in school/poor handwriting (chorea)
short of breath (severe carditis)
erythema marginatum
subcutaneous nodules

Use of Jones criteria, most common in young children in poor areas

Question 2

What leads to rheumatic fever?

Answer 2

Streptococcal pyogenes causing pharyngitis, followed by autoimmune response

Question 3

What does Jones criteria say?

Answer 3

Major and minor symptoms (list of these)
Must have throat swab show presence of group A streptococcal bacteria

Strep confirmed plus 2 major criteria or one major and two minor

Question 4

What are risk factors for rheumatic fever?

Answer 4

Social- poor housing/crowding; low decile education
Health- not equal access to healthcare
Economic: poverty
Ethnic-disparities, particularly with poverty

Question 5

What is important in streptococcal management?

Answer 5

A 10 day treatment of oral penicillin or amoxycillin or a long lasting benzathine penicillin