Rheumatic fever

Question 1

How is RF diagnosed?

Answer 1

• not a single test to diagnose it, it is clinical based on JONES CRITERIA

Question 2

What are 5 major manifestations of acute RF?

Answer 2

• carditis
• chorea
• arthritis/ arthralgia
• erythema marginatum
• subcutaneous nodules

All other manifestations can resolve but CARDITIS can lead to chronic rheumatic disease.

Question 3

Diagnostic factors in RF?

Answer 3

Fever (at onset usually)
Joint pain (symmetrical joints involved- polyarthritis)
Less common:
- recent sore throat or scarlet fever
- chest pain + SoB
- palpitations + murmur
- swollen joints
- pericardial rub

Question 4

Investigations in RF?

Answer 4

ESR, CRP, WBC
ECG, echo
CXR
Throat culture, rapid antigen test for IgA, anti-strep serology

Question 5

Treatment of RF?

Answer 5

1- Analgesia (paracetamol…)
2- Salicylate therapy OR NSAIDS (for joint pain)
3- ABx (penicillin)

IM penicillin can also be used as prophylaxis for the futue.