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Understanding Acute Rheumatic Fever

Acute rheumatic fever is an inflammatory disease that can affect the heart, joints, nervous system, and skin after a streptococcal throat infection. It is caused by group A beta-hemolytic streptococcus. Symptoms include carditis, polyarthritis, chorea, erythema marginatum, and subcutaneous nodules. Treatment focuses on relieving symptoms with salicylates, rest, and benzathine penicillin injections to prevent recurrence. Long term complications are usually cardiac in nature.

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Michelle Vera Gabun
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7 views1 page

Understanding Acute Rheumatic Fever

Acute rheumatic fever is an inflammatory disease that can affect the heart, joints, nervous system, and skin after a streptococcal throat infection. It is caused by group A beta-hemolytic streptococcus. Symptoms include carditis, polyarthritis, chorea, erythema marginatum, and subcutaneous nodules. Treatment focuses on relieving symptoms with salicylates, rest, and benzathine penicillin injections to prevent recurrence. Long term complications are usually cardiac in nature.

Uploaded by

Michelle Vera Gabun
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Acute Rheumatic Fever Pathophysiology

Definition: An inflammatory disease of the heart, joints,


central nervous system and subcutaneous tissues that
develops after a nasopharyngeal infection by one of the
group A beta-hemolytic streptococci.

Etiology: Group A beta-hemolytic streptococci

Epidemiology (PPS, 2014)


 12.6% in URTI
 58.7 with skin infection
 2.6-4.1% asymptomatic
 Peak incidence at 10-12 years old
 Increasing frequency of early onset of carditis
and valvulitis among children

Clinical Manifestations
 Major
o Carditis
o Polyarthritis
o Chorea
o Erythema marginatum
o Subcutaneous nodules
 Minor
o Clinical Findings
 Arthralgia
 Fever
o Laboratory Findings Treatment
 Elevated acute phase-reactants  Therapy for acute rheumatic fever is
 Elevated c-reactive protein symptomatic.
 Prolonged PR interval  Salicylate therapy for joint inflammation and
fever
Supportive evidence of antecedent group A  Restriction of physical activity until rheumatic
streptococcal infection process has become quiescent.
1. Positive throat culture or rapid streptococcal  All patients should receive benzathine penicillin.
antigen test
2. Elevated or rising streptococcal antibody titer Complications
 The arthritis and chorea of acute rheumatic
***If supported by evidence of preceding group A fever resolve completely without sequelae.
streptococcal infection, the presence of TWO MAJOR or  The long-standing sequelae of rheumatic fever
of ONE MAJOR AND TWO MINOR manifestations are usually limited to the heart.
indicates a high probability of acute rheumatic fever.
Prevention
Diagnosis  Penicillin prophylaxis is well established in its
 ERS, CRP, ASO titer ability to prevent recurrent attacks.
 CXR
 2D echo
 Throat culture

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