Rheumatic fever
Updates to Article Attributes
Rheumatic fever is a multisystemic inflammatory disorder caused by Type type II hypersensitivity reaction following group group A beta beta haemolytic streptococcus pharyngeal infection. Cross reaction of antibodies against protein M with other cells glycoproteins leads leads to involvement of other organs such such as heart.
Pathology
It principally involves the heart (pancarditis can result result), joints (see article: Jaccoud arthropathy), central nervous system, skin, and subcutaneous tissue.
Clinical diagnosis
Diagnosis
Jones criteria
Evidence of group A beta beta haemolytic streptococcus infection streptococcus infection and
- 2 major
OR - or 1 major and 2 minor criterias .
Major
- fever
- arthralgia
- increase in acute phase reactants (e.g. CRP/ESR)
- previous episode of rheumatic fever or inactive heart disease
- leukocytosis
- ECG changes
suchsuch as a prolongedPRPR interval(notifif carditis is present as a major symptom) -
see article:Jaccoud arthropathy
Musculoskeletal manifestations
Pathology
Histology
- Aschoff bodies
- lymphocytes
- swollen collagen
- plump macrophages (Anitschkow cells): pathognomonic
- Anitschkow cells can fuse to become multinucleated cells (Aschoff cells)
Treatment and prognosis
Benzathine penicillin 120IU IM120 IU intramusacular injuection is the drug of choice to eliminate group A streptococci. While good supportive therapy can reduce the mortality and morbidity of the disease.
The clinical course can varies greatly, but in general, ~75% of acute rheumatic attacks subside within 6 weeks.
-<p><strong>Rheumatic fever </strong>is a multisystemic inflammatory disorder caused by Type II hypersensitivity reaction following group A beta haemolytic streptococcus pharyngeal infection. Cross reaction of antibodies against protein M with other cells glycoproteins leads to involvement of other organs such as heart. </p><p>It principally involves the heart (pancarditis can result), joints, central nervous system, skin, and subcutaneous tissue. </p><h4>Clinical diagnosis</h4><h5>Jones criteria</h5><p>Evidence of group A beta haemolytic streptococcus infection and</p><ul>-<li>2 major <strong>OR </strong>-</li>-<li>1 major <strong>and</strong> 2 minor criterias </li>-</ul><h6>Major criteria</h6><ol>- +<p><strong>Rheumatic fever </strong>is a multisystemic inflammatory disorder caused by type II hypersensitivity reaction following group A beta haemolytic streptococcus pharyngeal infection. Cross reaction of antibodies against protein M with other cells glycoproteins leads to involvement of other organs such as heart. </p><h4>Pathology</h4><p>It principally involves the heart (pancarditis can result), joints (see article: <a href="/articles/jaccoud-arthropathy">Jaccoud arthropathy</a>), central nervous system, skin, and subcutaneous tissue. </p><h5>Diagnosis</h5><h6>Jones criteria</h6><p>Evidence of group A beta haemolytic streptococcus infection and 2 major or 1 major and 2 minor criterias.</p><ul>
- +<li>major criteria<ul>
-</ol><h6>Minor criteria</h6><ol>- +</ul>
- +</li>
- +<li>minor criteria<ul>
-<li>ECG changes such as a prolonged PR interval (not if carditis is present as a major symptom)</li>-</ol><h5>Musculoskeletal manifestations </h5><ul><li>see article: <a href="/articles/jaccoud-arthropathy">Jaccoud arthropathy</a>-</li></ul><h4>Pathology</h4><h5>Aschoff bodies</h5><ul>- +<li>ECG changes such as a prolonged PR interval (not if carditis is present as a major symptom)</li>
- +</ul>
- +</li>
- +</ul><p><span style="font-size:15.6px; line-height:12.48px"><strong>Histology</strong></span></p><ul>
- +<li>Aschoff bodies</li>
-</ul><h4>Treatment and prognosis</h4><p>Benzathine penicillin 120IU IM is the drug of choice to eliminate group A streptococci. While good supportive therapy can reduce the mortality and morbidity of the disease.</p><p>The clinical course can varies greatly, but in general, ~75% of acute rheumatic attacks subside within 6 weeks. </p>- +</ul><h4>Treatment and prognosis</h4><p>Benzathine penicillin 120 IU intramusacular injuection is the drug of choice to eliminate group A streptococci. While good supportive therapy can reduce the mortality and morbidity of the disease.</p><p>The clinical course can varies greatly, but in general, ~75% of acute rheumatic attacks subside within 6 weeks. </p>
Image 1 X-ray (Frontal) ( create )
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