Rheumatic Fever Flashcards
What is rheumatic fever?
Complication that can occur after a throat infection
What is the common causative organism?
Group A beta-haemolytic streptococcus
How is the diagnosis made?
Revised Jones criteria = recent strep infection + 2 major OR 1 major + 2 minor
Major criteria
- carditis
- arthritis
- subcutaeneous nodules
- erythema marginatum
- Sydenham’s chorea
Minor criteria
- fever
- raised CRP or ESR
- prolonged P-R interval
- arthralgia
What are the symptoms?
Previous sore throat
Fever Arthritis Chorea Chest pain Dyspnoea Palpitations Erythema marginatum
Systolic murmur
Pericardial rub
What is erythema marginatum?
Rash with raised red edges and clear centre
Commonly on trunk and arms
What is Sydenham’s chorea?
Unilateral or bilateral involuntary jerking movements
What investigations do you need to do?
Bloods Throat swab ECG Echo CXR Blood cultures Antistreptolysin 0 titres
What is antistreptolysin 0 titres?
Confirmation of streptococcus infection
What is the ECG change in rheumatic fever?
P-R lengthened
How is rheumatic fever managed?
Bed rest until inflammatory markers decrease
Stat 1.2g IM benzylpenicillin
PO penicillin
Aspirin
What secondary prophylaxis is required?
Daily penicillin until >30
What can cause repeat carditis?
Pregnancy
Contraceptive pill
Streptococcal infection
What valve is most commonly affected?
Mitral
