Rheumatic Fever

[ Home ] [ Up ]

Pages Below:

Rheumatic Fever

  • after pharyngeal infection with group A streptococcus (Strep pyogenes)
  • first attack usually occurs in children / young adults
  • affects heart, skin, joints and CNS

Pathology

  • all three layers of heart
  • Aschoff nodules in myocardium (esp. subendocardium of left ventricle)
    • granulomatous
    • central necrotic area
  • small, warty vegetations on heart valves
  • acute pericarditis
  • inflamed synovial membranes
  • subcutaneous nodules

History

  • sudden onset
  • fever
  • joint pains
  • malaise
  • anorexia

Diagnosis

  • 2 major criteria
  • 1 major and two minor

Jones Criteria

Major

  • Carditis
  • Migratory polyarthritis
  • Erythema Marginatum
  • Chorea (Sydenham's Chorea)
  • Subcutaneous nodules

Minor

  • Fever
  • Arthralgia
  • Previous rheumatic fever
  • elevated ESR / CRP
  • Prolonged PR interval on ECG
  • Evidence of preceding Group A Streptococcal infection

Treatment

 

[ Home ] [ Up ]