Tuesday, June 26, 2012

Rheumatic fever

Rheumatic fever
Rheumatic fever is an inflammatory disease that occurs following a Streptococcus pyogenes infection, such as streptococcal pharyngitis or scarlet fever. Believed to be caused by antibody cross-reactivity that can involve the heart, joints, skin and brain.

Jones criteria
Jones criteria are guidelines decided on by the American Heart Association to help doctors clinically diagnose rheumatic fever. Two major criteria or one major and two minor plus a history of a streptococcal throat infection are required to make the diagnosis of rheumatic fever.
 
The major criteria for diagnosis include
arthritis in several joints (polyarthritis),
heart inflammation (carditis),
nodules under the skin (subcutaneous nodules or Aschoff bodies),
rapid, jerky movements (Sydenham's chorea), and
skin rash (erythema marginatum).

The minor criteria include
fever,
high ESR (erythrocyte sedimentation rate, an laboratory sign of inflammation),
joint pain (arthralgia),
EKG changes (electrocardiogram), and
other laboratory findings (elevated C-reactive protein, elevated or rising streptococcal antigen test).


Other signs and symptoms
Abdominal pain
Nose bleeds
Preceding streptococcal infection: recent scarlet fever, raised antistreptolysin O or other streptococcal antibody titre, or positive throat culture.


 Prevention of Rheumatic Fever

Physicians do not know how to slow the process that damages the heart valves. Therefore, preventing rheumatic fever is the most effective way to "treat" the disease.

The initial episode of rheumatic fever usually can be prevented by early treatment of streptococcal pharyngitis (strep throat) with antibiotics.