Rheumatic fever

Question 1

Rheumatic fever cause

Answer 1

• Acute group A streptococcal pharyngitis, usually occurs 2-4 weeks after acute infection.
• Rare in the US and developed countries.
• 72% of children with acute rheumatic fever develop chronic valvular disease. Symptoms of valvular dysfunction on average occur 20 years after acute infection.
• Most common cause of mitral stenosis and tricuspid stenosis.

Question 2

Rheumatic fever diagnostic criteria

Answer 2

Modified Jones diagnostic criteria: Preceding group A strep infection with 2 major OR 1 major and 2 minor.

• Major: Carditis (presents with no heart symptoms), polyarthritis (no joint deformities, negative rheumatoid factor), chorea, erythema marginatum, subcutaneous nodules
• Minor: Previous rheumatic fever, arthralgias, fever, acute phase reactants (high ESR or WBC), prolonged PR interval on EKG.

-Unlike rheumatoid arthritis, does not cause joint deformities, negative rheumatoid factor.